改良Beck口腔评估法联合HC可视喉镜在气管插管患者口腔护理中的应用
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摘要
目的探讨改良Beck口腔评估法联合HC可视喉镜在气管插管患者口腔护理中的应用效果。方法将80例气管插管患者随机分为对照组和实验组,每组40例,对照组给予常规口腔护理,实验组采用改良Beck口腔评估法联合HC可视喉镜进行口腔护理,比较两组患者口腔各部位并发症发生率、口腔异味评分、牙菌斑指数及改良Beck口腔评估法评分情况,比较护士对两种口腔护理方法及效果的满意度。结果两组患者口腔各部位并发症发生率比较差异无统计学意义(P> 0. 05);实验组患者口腔异味评分及牙菌斑指数、牙龈/口腔黏膜、舌头、分泌物的改良Beck口腔评估法评分以及总分均低于对照组(均P <0. 05);护士对实验组口腔护理操作方法及护理效果的满意度均高于对照组(P <0. 05)。结论与传统口腔护理方法比较,应用改良Beck口腔评估法动态评估口腔情况,并在HC可视喉镜辅助下对气管插管患者进行口腔护理的效果更好。
引文
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[2]Feider LL,Mitchell P,Bridges E.Oral care practices for orally intubated critically ill adults[J].Am J Crit Care,2010,19(2):175-183.
[3]王婉洁.基于Beck口腔评分的综合口腔护理干预方案在气管插管病人中的应用研究[D].广州:南方医科大学,2014.
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[5]魏兵,李春盛.光学喉镜与普通喉镜在急诊气管插管的对比研究[J].中华急诊医学杂志,2011,20(1):70-73.
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[8]单海华,陈红芳,李华,等.过氧化氢术前含漱预防全麻术后口腔异味的临床观察[J].临床麻醉学杂志,2006,22(7):542.
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[11]樊蕴莉,常秋芳,张琳.预防呼吸机相关性肺炎口咽部清洁方法研究[J].中华医院感染学杂志,2015,25(12):2 777-2 779.
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[13]王婉洁,李亚洁,刘晓玲.基于Beck口腔评分的综合口腔护理干预体系在气管插管病人中的应用[J].护理学报,2014,21(10):1-4,5.
[14]杨磊.成人ICU经口气管插管病人口腔护理实施现状与分析[J].护理研究,2012,26(12):1 086-1 088.
[15]Wise MP,Williams DW.Oral Biofilms,Systemic Disease,and Pneumonia[J].Annual Update in Intensive Care and Emergency Medicine,2012,2012:278-288.
[16]江方正,杨洁,叶向红.机械通气患者口腔护理新进展[J].解放军护理杂志,2013,30(12):33-36,45.
[17]徐建宁,冯洁惠.ICU经口气管插管口腔护理实践指引的制订及临床应用[J].解放军护理杂志,2016,33(7):50-54.
[18]Kaya H,Turan Y,Tunali Y,et al.Effects of oral care with glutamine in preventing ventilator-associated pneumonia in neurosurgical intensive care unit patients[J].Appl Nur Res,2017,33:10-14.
[19]El-Solh AA.Association between pneumonia and oral care in nursing home residents[J].Lung,2011,189(3):173-180.
[20]王洪冰,李佩珍.老年人吸入性肺炎的诊治难点和对策[J].中华老年医学杂志,2006,25(5):325-327.
[21]茅新蕾,韩丽雅,黄向东,等.脑卒中相关性肺炎危险因素分析[J].中华医院感染学杂志,2011,21(11):2 199-2 201.
[22]Zuanazzi D,Souto R,Mattos MB,et al.Prevalence of potential bacterial respiratory pathogens in the oral cavity of hospitalised individuals[J].Arch Oral Biol,2010,55(1):21-28.
[23]Scannapieco FA,Stewart EM,Mylotte JM.Colonization of dental plaque by respiratory pathogens in medical intensive care patients[J].Crit Care Med,1992,20(6):740-745.
[24]Berry AM,Davidson PM,Masters J,et al.Systematic literature review of oral hygiene practices for intensive care patients receiving mechanical ventilation[J].Am J Crit Care,2007,16(6):552-562;quiz 563.
[2]Feider LL,Mitchell P,Bridges E.Oral care practices for orally intubated critically ill adults[J].Am J Crit Care,2010,19(2):175-183.
[3]王婉洁.基于Beck口腔评分的综合口腔护理干预方案在气管插管病人中的应用研究[D].广州:南方医科大学,2014.
[4]程浩,屈美敏,马丙强,等.可视喉镜用于非麻醉专业人员气管插管术培训[J].临床急诊杂志,2009,10(5):306-307.
[5]魏兵,李春盛.光学喉镜与普通喉镜在急诊气管插管的对比研究[J].中华急诊医学杂志,2011,20(1):70-73.
[6]李小寒,尚少梅.基础护理学[M].第4版.北京:人民卫生出版社,2006:64-67.
[7]林小清,熊小兰,沈碧强,等.经口气管插管机械通气病人3种口腔护理方法的临床效果比较[J].护理研究,2015,29(13):1 562-1 564.
[8]单海华,陈红芳,李华,等.过氧化氢术前含漱预防全麻术后口腔异味的临床观察[J].临床麻醉学杂志,2006,22(7):542.
[9]卞金有.预防口腔医学[M].5版.北京:人民卫生出版社,2007:56.
[10]燕玲,李惠萍,周鹏,等.心血管手术患者术前牙菌斑对术后肺部感染的影响[J].中华护理杂志,2011,46(12):1 204-1 206.
[11]樊蕴莉,常秋芳,张琳.预防呼吸机相关性肺炎口咽部清洁方法研究[J].中华医院感染学杂志,2015,25(12):2 777-2 779.
[12]Ames NJ,Sulima P,Yates JM,et al.Effects of systematic oral care in critically ill patients:a multicenter study[J].Am J Crit Care,2011,20(5):e103-e114.
[13]王婉洁,李亚洁,刘晓玲.基于Beck口腔评分的综合口腔护理干预体系在气管插管病人中的应用[J].护理学报,2014,21(10):1-4,5.
[14]杨磊.成人ICU经口气管插管病人口腔护理实施现状与分析[J].护理研究,2012,26(12):1 086-1 088.
[15]Wise MP,Williams DW.Oral Biofilms,Systemic Disease,and Pneumonia[J].Annual Update in Intensive Care and Emergency Medicine,2012,2012:278-288.
[16]江方正,杨洁,叶向红.机械通气患者口腔护理新进展[J].解放军护理杂志,2013,30(12):33-36,45.
[17]徐建宁,冯洁惠.ICU经口气管插管口腔护理实践指引的制订及临床应用[J].解放军护理杂志,2016,33(7):50-54.
[18]Kaya H,Turan Y,Tunali Y,et al.Effects of oral care with glutamine in preventing ventilator-associated pneumonia in neurosurgical intensive care unit patients[J].Appl Nur Res,2017,33:10-14.
[19]El-Solh AA.Association between pneumonia and oral care in nursing home residents[J].Lung,2011,189(3):173-180.
[20]王洪冰,李佩珍.老年人吸入性肺炎的诊治难点和对策[J].中华老年医学杂志,2006,25(5):325-327.
[21]茅新蕾,韩丽雅,黄向东,等.脑卒中相关性肺炎危险因素分析[J].中华医院感染学杂志,2011,21(11):2 199-2 201.
[22]Zuanazzi D,Souto R,Mattos MB,et al.Prevalence of potential bacterial respiratory pathogens in the oral cavity of hospitalised individuals[J].Arch Oral Biol,2010,55(1):21-28.
[23]Scannapieco FA,Stewart EM,Mylotte JM.Colonization of dental plaque by respiratory pathogens in medical intensive care patients[J].Crit Care Med,1992,20(6):740-745.
[24]Berry AM,Davidson PM,Masters J,et al.Systematic literature review of oral hygiene practices for intensive care patients receiving mechanical ventilation[J].Am J Crit Care,2007,16(6):552-562;quiz 563.