采取综合干预措施可降低口腔癌患者术后下呼吸道感染率

Taking comprehensive intervention measures to reduce postoperative lower respiratory tract infection in patients with oral cancer

摘要:

目的探讨综合干预措施对降低口腔癌患者术后下呼吸道感染的效果。方法干预组：某院2012年9月—2013年3月收治的146例口腔癌患者，同期在其围手术期加强实施针对预防下呼吸道感染的综合干预措施；对照组：该院2012年3—8月收治的140例口腔癌患者，执行一般诊疗护理常规，比较两组患者术后下呼吸道感染情况。结果干预组患者术后床头抬高30°、术前术后使用复方洗必泰含漱液口腔护理、全麻喉镜头高压灭菌、全麻气管插管前手卫生以及雾化吸入庆大霉素5项干预措施的执行率均高于对照组，差异均有统计学意义（均P＜0.01）。 干预组下呼吸道感染率为0.68%（1例），低于对照组的5.71%（8例），差异有统计学意义（χ2＝4.39，P＜0.05）。结论实施综合干预措施，能有效降低口腔癌患者手术后下呼吸道感染率。

关键词:

口腔癌; 下呼吸道感染; 综合干预措施; 效果评价

Abstract:

ObjectiveTo evaluate the effectiveness of comprehensive intervention measures in reducing postoperative lower respiratory tract infection (LRTI)  in patients with oral cancer.MethodsPatients were divided into intervention group and control group, intervention group :146 patients who admitted to a hospital between September 2012 and March 2013 received comprehensive intervention measures during perioperative period for preventing postoperative LRTI; control group: 140 patients who admitted to the hospital between March and August 2012 received routine medical care, incidence of postoperative LRTI between two groups was compared.ResultsThe implementation rates of 5 intervention measures of intervention group (30° bed head elevation, oral rinse with compound chlorhexidine gargle, autoclave sterilization of head of laryngoscope used in general anaesthesia, hand hygiene before anaesthesia for endotracheal intubation, and  gentamycin inhalation) were all higher than control group (all P<0.01). Incidence of LRTI in intervention group was significantly lower than control  group (［0.68%,n=1］ vs ［5.71%,n=8］, χ2＝4.39，P＜0.05）.ConclusionThe implementation of comprehensive intervention measures can effectively reduce the incidence of postoperative LRTI in patients with oral cancer.

Key words:

oral cancer; lower respiratory tract infection; comprehensive intervention measure; effectiveness ; evaluation ;