苯扎氯铵口腔护理预防脑梗死机械通气患者呼吸机相关性肺炎的临床研究
|
摘要
目的探讨苯扎氯铵口腔护理对预防脑梗死机械患者发生呼吸机相关肺炎(Ventilator Associated Pneumonia,VAP)的作用。方法选取在2013年7月—2016年10月期间该院重症监护病房(Intensive Care Units,ICU)收治的大面积脑梗死行气管插管,呼吸机械通气患者,依据家属自愿原则分为观察组50例,对照组50例。观察组采取苯扎氯铵口腔护理方法(3次/d),对照组采用口腔常规棉球擦拭的护理方法(3次/d),分析二种口腔护理方法对口腔功能改善和VAP发生率的影响。结果观察组患者的口腔功能较对照组显著改善,观察组患者的VAP发生率明显低于对照组,差异具有统计学意义(P<0.05),观察组患者的VAP千日感染率低于对照组(P<0.05)。结论苯扎氯铵口腔护理可以有效降低大面积脑梗死机械通气患者VAP的感染率。
Objective To observe the effects of different ways of oral care preventing ventilator associated pneumonia in cerebral infarction patients.Methods One hundred cerebral infarction patients with mechanical ventilation in ICU during Junly 2013 to October 2016 were divided into study group(50 cases)and control group(50 cases).The study group received oral nursing by Benz-alkonium Chloride 3times per day,while the control group was given oral nursing by Stroke-physiological saline solution 3 times per day.And then we analyzed the impact of two methods on oral function and the incidence of VAP.Results The oral function of the study group was improved significantly and the incidence of VAP of the study group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).The VAP incidence rate of every 1000 days of the study group was significantly lower than that of the control group,the difference was also statistically significant(P<0.05).Conclusions Oral nursing by Benz- alkonium Chloride can significantly improve the oral function,reduce VAP infection rate and VAP incidence rate of every 1 000 days in cerebral infarction patients with mechanical ventilation
Objective To observe the effects of different ways of oral care preventing ventilator associated pneumonia in cerebral infarction patients.Methods One hundred cerebral infarction patients with mechanical ventilation in ICU during Junly 2013 to October 2016 were divided into study group(50 cases)and control group(50 cases).The study group received oral nursing by Benz-alkonium Chloride 3times per day,while the control group was given oral nursing by Stroke-physiological saline solution 3 times per day.And then we analyzed the impact of two methods on oral function and the incidence of VAP.Results The oral function of the study group was improved significantly and the incidence of VAP of the study group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).The VAP incidence rate of every 1000 days of the study group was significantly lower than that of the control group,the difference was also statistically significant(P<0.05).Conclusions Oral nursing by Benz- alkonium Chloride can significantly improve the oral function,reduce VAP infection rate and VAP incidence rate of every 1 000 days in cerebral infarction patients with mechanical ventilation
引文
[1]Chinnadurai K,Fenlason L,Bridges B,et al.Implementation of a Sustainable Ventilator-Associated Pneumonia Prevention Protocol in a Pediatric Intensive Care Unit in Managua,Nicaragua[J].Dimens Crit Care Nurs,2016,35(6):323-331
[2]K SR.A study of ventilator associated pneumonia risk factors and outcomes[J].J Assoc Physicians India,2016,64(1):118
[3]Gupta A,Gupta A,Singh TK,et al.Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients[J].Saudi J Anaesth,2016,10(1):95-97
[4]Cutler LR,Sluman P.Reducing ventilator associated pneumonia in adult patients through high standards of oral care:a historical control study[J].Intensive Crit Care Nurs,2014,30(2):61-68
[5]柳瑞丽.经口气管插管105例口腔护理[J].中国煤炭工业医学杂志,2012,15(2):268
[6]Liao YM,Tsai JR,Chou FH.The effectiveness of an oral health care program for preventing ventilator-associated pneumonia[J].Nurs Crit Care,2015,20(2):89-97
[7]Rosseau S,Schutte H,Suttorp N.Ventilator-associated pneumonia[J].Internist(Berl),2013,54(8):954-962
[8]Arweiler NB,Netuschil L.The Oral Microbiota[J].Adv Exp Med Biol,2016,902:45-60
[9]Safdar N,Crnich CJ,Maki DG.The pathogenesis of ventilator-associated pneumonia:its relevance to developing effective strategies for prevention[J].Respir Care,2005,50(6):725-739;739-741
[10]Munro CL,Grap MJ.Oral health and care in the intensive care unit:state of the science[J].Am J Crit Care,2004,13(1):25-33;34
[11]DeJohn P.Hospitals save millions on VAP with oral care program[J].Hosp Mater Manage,2006,31(3):1-2
[12]李存利.碘伏在妇科手术前阴道准备中的应用[J].现代医药卫生,2005,21(14):1823
[13]石秀慧,朱敏.宫颈癌术前聚维酮碘阴道灌洗与阴道擦洗消毒效果的对比[J].解放军护理杂志,2007,24(11A):14215
[14]徐艳.预防性护理对老年呼吸衰竭患者呼吸机相关肺炎发生率的影响[J].中国煤炭工业医学杂志,2015,18(2):314-316
[15]Bellissimo-Rodrigues WT,Menequeti MG,Gaspar GG,et al.Effectiveness of a dental care intervention in the prevention of lower respiratory tract nosocomial infections among intensive care patients:a randomized clinical trial[J].Infect Control Hosp Epidemiol,2014,35:1342-1348
[2]K SR.A study of ventilator associated pneumonia risk factors and outcomes[J].J Assoc Physicians India,2016,64(1):118
[3]Gupta A,Gupta A,Singh TK,et al.Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients[J].Saudi J Anaesth,2016,10(1):95-97
[4]Cutler LR,Sluman P.Reducing ventilator associated pneumonia in adult patients through high standards of oral care:a historical control study[J].Intensive Crit Care Nurs,2014,30(2):61-68
[5]柳瑞丽.经口气管插管105例口腔护理[J].中国煤炭工业医学杂志,2012,15(2):268
[6]Liao YM,Tsai JR,Chou FH.The effectiveness of an oral health care program for preventing ventilator-associated pneumonia[J].Nurs Crit Care,2015,20(2):89-97
[7]Rosseau S,Schutte H,Suttorp N.Ventilator-associated pneumonia[J].Internist(Berl),2013,54(8):954-962
[8]Arweiler NB,Netuschil L.The Oral Microbiota[J].Adv Exp Med Biol,2016,902:45-60
[9]Safdar N,Crnich CJ,Maki DG.The pathogenesis of ventilator-associated pneumonia:its relevance to developing effective strategies for prevention[J].Respir Care,2005,50(6):725-739;739-741
[10]Munro CL,Grap MJ.Oral health and care in the intensive care unit:state of the science[J].Am J Crit Care,2004,13(1):25-33;34
[11]DeJohn P.Hospitals save millions on VAP with oral care program[J].Hosp Mater Manage,2006,31(3):1-2
[12]李存利.碘伏在妇科手术前阴道准备中的应用[J].现代医药卫生,2005,21(14):1823
[13]石秀慧,朱敏.宫颈癌术前聚维酮碘阴道灌洗与阴道擦洗消毒效果的对比[J].解放军护理杂志,2007,24(11A):14215
[14]徐艳.预防性护理对老年呼吸衰竭患者呼吸机相关肺炎发生率的影响[J].中国煤炭工业医学杂志,2015,18(2):314-316
[15]Bellissimo-Rodrigues WT,Menequeti MG,Gaspar GG,et al.Effectiveness of a dental care intervention in the prevention of lower respiratory tract nosocomial infections among intensive care patients:a randomized clinical trial[J].Infect Control Hosp Epidemiol,2014,35:1342-1348