不同浓度氯己定口腔护理液在经口气管插管患者中的应用

Application of different concentrations of chlorhexidine oral care solution in patients with orotracheal intubation

摘要:

目的探讨不同浓度氯己定口腔护理液在经口气管插管患者中的应用效果。方法2012年1月—2013年12月某院综合ICU收治的经口气管插管行机械通气时间＞48 h以上患者，共纳入120例符合条件患者，随机分为3组，每组各40例。使用不同浓度氯己定口腔护理液应用于各组患者：试验组（2%）、对照组Ⅰ（0.2%）、对照组Ⅱ（0.12%）。观察并比较3组患者在口臭、口腔黏膜感染、呼吸机相关肺炎（VAP）发生时间及VAP发病率的差异。结果试验组与对照组Ⅰ、对照组Ⅱ患者的VAP、早发VAP的发病率比较差异有统计学意义（均P＜0.05）；进一步两两比较，对照组Ⅱ患者VAP发病率高于试验组（47.50% VS 20.00%，P=0.009）。结论应用2%氯己定与有效的冲洗加擦拭口腔护理方法可有效降低经口气管插管患者的VAP发病率。

Abstract:

ObjectiveTo study application effectiveness of different concentrations of chlorhexidine oral care solution in patients with orotracheal intubation. MethodsA total of 120 patients who were admitted to the general intensive care unit (ICU) of a hospital and undergoing mechanical ventilation via orotracheal intubation for >48 hours between January 2012  and  December 2013 were included in the study, they were divided randomly into three groups, 40 in each group. Trial group, control group I, and control group II were provided with 2%,0.2%, and 0.12% chlorhexidine oral care solution, respectively. Differences in halitosis, oral mucosal infection, onset time and incidence of ventilatorassociated pneumonia (VAP) among  three groups were observed and compared. ResultsThere were  significant difference in incidence of VAP  and earlyonset VAP between trial group and  control group I, trial group and  control group II, respectively(both P<0.05); incidence of  VAP in  control group II was higher than trial group（47.50% vs 20.00%，P=0.009）. Conclusion2% chlorhexidine oral rinsing and swabbing can effectively reduce incidence of VAP in patients with orotracheal intubation.