| 邢斌瑜,申存毅,林婷,等.冲洗和擦拭对 ICU气管插管病人口腔菌群水平的影响分析[J].安徽医药,2024,28(12):2367-2371. |
| 冲洗和擦拭对 ICU气管插管病人口腔菌群水平的影响分析 |
| Analysis of influence of irrigation and wiping on oral microflora level of patients with tracheal intubation in ICU |
| |
| DOI：10.3969/j.issn.1009-6469.2024.12.007 |
| 中文关键词: 口腔护理 插管法，气管内 呼吸机相关性肺炎 重症监护病房 口腔菌群 口腔擦拭 口腔冲洗 |
| 英文关键词: Oral care Intubation, intratracheal Ventilators associated pneumonia Intensive care unit Oral microflora Oral swab Oral irrigation |
| 基金项目:陕西省重点研发计划项目( 2023-YBSF-421) |
|
| 摘要点击次数: 535 |
| 全文下载次数: 265 |
| 中文摘要: |
| 目的探讨冲洗和擦拭对重症监护病房( ICU)气管插管病人口腔菌群水平的影响。方法选取 2021年 1月至 2022年 12月西安交通大学第一附属医院 ICU行气管插管病人 180例，均予以口腔护理，按照随机数字表法分为擦拭组 60例，采用 0.9%氯化钠溶液进行常规口腔擦拭，每天 3次；冲洗组 60例，予以 0.9%氯化钠溶液口腔冲洗，每天 3次；联合组 60例，插管前口腔擦拭，插管后采取口腔擦拭联合冲洗方式，每天 3次。对比三组机械通气时间、 ICU住院时间、口腔菌群水平、口腔卫生情况。采用 Kaplan-Meier曲线分析三组呼吸机相关性肺炎( VAP)发生情况。结果三组机械通气、 ICU住院时间对比差异有统计学意义( P<0.05)联合组机械通气时间、 ICU住院时间较冲洗组和擦拭组缩短( P<0.017)；三组插管后 8h、16 h、24 h口腔护理后口腔菌群水比差异有统计学意义( P<0.05)联合组插管后 8h、16 h［( 5.02±0.67)lgCFU/g比( 5.39±0.68)lgCFU/g、(5.41± 平对，0.66)lgCFU/g］、 24 h口腔护理后菌落计数较冲洗擦拭组少( P<0.017)；三组插管后第 7天口腔清洁度及菌斑指数评分对比差异有统计学意义( P<0.05)联合组插管后第 7天口腔清洁度及菌斑指数评分较冲洗组和擦拭组低( P<0.017)； Kaplan-Meier组和，曲线分析显示三组 VAP发生率，对比差异有统计学意义( P<0.05)联合组 VAP发生率较冲洗组和擦拭组低( P<0.017)。结论冲洗联合擦拭口腔护理方式有效改善 ICU气管插管病人口腔菌群和，口腔卫生情况，降低 VAP发生率，缩短机械通气时间和住院时间。 |
| 英文摘要: |
| Objective To investigate the effects of irrigation and wiping on oral microflora before and after endotracheal intubation inintensive care unit (ICU).Methods A total of 180 patients receiving tracheal intubation in the ICU of the First Affiliated Hospital ofXi'an Jiaotong University from January 2021 to December 2022 were selected, and all of them were given oral care. According to ran-dom number table method, 60 cases were divided into wiping group. Normal saline was used for routine oral wiping, 3 times a day. Inthe irrigation group, 60 cases were given oral irrigation with normal saline, 3 times a day; In the combined group, 60 cases were givenoral wiping before intubation and oral wiping combined with irrigation after intubation, 3 times a day. The mechanical ventilation time,ICU stay time, oral flora level and oral hygiene of the three groups were compared. Kaplan-Meier curve was used to analyze the inci-dence of ventilators associated pneumonia (VAP) in the three groups.Results The mechanical ventilation time and ICU stay time of the three groups were significantly different (P<0.05), and the mechanical ventilation time and ICU stay time of the combined groupwere shorter than those of the washing group and the wiping group (P<0.017). There were statistically significant differences in the levelof oral flora after 8 h, 16 h and 24 h oral care among the three groups (P<0.05), and the number of bacterial colonies in the combinedgroup after 8 h, 16 h and 24 h oral care was lower than that in the rinsing and wiping groups (P<0.017). There were statistically signifi-cant differences in oral cleanliness and plaque index scores on 7 d after intubation among the three groups (P<0.05), and the oral clean-liness and plaque index scores on 7 d after intubation in the combined group were lower than those in the rinsing and wiping groups (P< 0.017). Kaplan-Meier curve analysis showed that there was a statistically significant difference in the incidence of VAP among the three groups (P<0.05), and the incidence of VAP in the combined group was lower than that in the washing group and the wiping group (P< 0.017).Conclusion Irrigation combined with oral wiping can effectively improve the oral flora and oral hygiene of patients with trache-al intubation in ICU, reduce the incidence of VAP, shorten the time of mechanical ventilation and hospital stay. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
