改良口腔护理方法对机械通气患者口腔卫生状况及呼吸机相关肺炎发生率的影响

杨芳; 方瑶; 韩志武

doi:10.16016/j.1000-5404.201908147

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改良口腔护理方法对机械通气患者口腔卫生状况及呼吸机相关肺炎发生率的影响

临床医学 | 更新时间：2026-01-09

- 改良口腔护理方法对机械通气患者口腔卫生状况及呼吸机相关肺炎发生率的影响
- Effect of improved oral care on oral health and incidence of ventilator-associated pneumonia in patients with mechanical ventilation
- 第三军医大学学报 2020年42卷第2期页码：2015-218, 封3
- 作者机构：
  
  430010 武汉，中国人民解放军中部战区总医院汉口院区呼吸内科
- 作者简介：
  
  [方瑶，E-mail: lolfang@sina.cn FANG Yao, E-mail: lolfang@sina.cn
- 基金信息：
- DOI：10.16016/j.1000-5404.201908147
  中图分类号： R473.5; R563.1; R605.973
- 收稿：2019-08-19，
  
  修回：2019-09-21，
  
  纸质出版：2020-01-30
- 稿件说明：
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杨芳, 方瑶, 韩志武. 改良口腔护理方法对机械通气患者口腔卫生状况及呼吸机相关肺炎发生率的影响[J]. 第三军医大学学报, 2020,42(2):2015-218, 封3.

Fang YANG, Yao FANG, Zhiwu HAN. Effect of improved oral care on oral health and incidence of ventilator-associated pneumonia in patients with mechanical ventilation[J]. Journal of Third Military Medical University, 2020, 42(2): 2015-218, 封3.
杨芳, 方瑶, 韩志武. 改良口腔护理方法对机械通气患者口腔卫生状况及呼吸机相关肺炎发生率的影响[J]. 第三军医大学学报, 2020,42(2):2015-218, 封3. DOI： 10.16016/j.1000-5404.201908147.

Fang YANG, Yao FANG, Zhiwu HAN. Effect of improved oral care on oral health and incidence of ventilator-associated pneumonia in patients with mechanical ventilation[J]. Journal of Third Military Medical University, 2020, 42(2): 2015-218, 封3. DOI： 10.16016/j.1000-5404.201908147.

摘要

目的

探讨改良口腔护理方法在改善重症监护室(ICU)行机械通气患者的口腔健康、降低罹患呼吸机相关性肺炎(ventilator-associated pneumonia

VAP)概率和促进患者脱机中的作用。

方法

选取2017年1月至2019年1月本院呼吸内科重症监护室(RICU)中接受有创机械通气治疗的88例患者作为研究对象，按随机数字表法分为2组，对照组44例，行常规口腔护理(棉球蘸漱口液擦拭)，试验组44例，给予改良口腔护理(采用儿童牙刷蘸过氧化氢溶液刷牙，配合生理盐水负压吸引法冲洗)。观察患者口腔卫生状况及相关口腔疾病症状发生率、呼吸道及人工气道病原菌检出率、呼吸机相关性肺炎发生率及RICU住院周期。

结果

试验组患者口腔状况较好，口臭、牙龈肿痛、口腔溃疡等口腔问题发生率低于对照组(

0.05)，呼吸道病原体初筛阳性率更低，且试验组患者呼吸机相关性肺炎发生率更低，RICU住院时间更短(

0.05)。

结论

与常规口腔护理相比，改良口腔护理对改善口腔卫生更有效，减少机会病原体的定植，降低呼吸机相关性肺炎发生概率，缩短患者ICU住院周期。

Abstract

Objective

To investigate the effect of improved oral care on oral health

incidence of ventilator-associated pneumonia and weaning from mechanical ventilation.

Methods

Eighty-eight patients receiving mechanical ventilation in the intensive care unit (ICU) of our department between January

2017 and January

2019 were enrolled in this study. The patients were randomized equally into control group and observation group to receive conventional oral care (using mouth wash) and improved oral care (brushing teeth with hydrogen peroxide and oral rinsing with saline and pressure suction)

respectively. Oral health

positive rates of pathogenic microorganisms in the respiratory tract and the ventilator

the incidence of ventilator-associated pneumonia and the length of ICU time were compared between the 2 groups.

Results

Compared with those in the control group

the patients in the observation group had better oral condition and lower incidences of halitosis

gingival swelling and pain

and oral ulcer (

0.05) and also lower detection rate

s of pathogenic microorganisms. The incidence of ventilator-associated pneumonia was significantly lower and the ICU time was significantly shorter in the observation group than in the control group (

0.05).

Conclusion

Compared with conventional oral care

the improved oral care achieves better oral cleanliness to effectively reduce the risk of oral problems and the incidence of ventilator-associated infection and shorten the ICU time of the patients with mechanical ventilation.

关键词

Keywords

references

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