氯己定擦浴降低神经外科ICU患者呼吸机相关肺炎的效果评价

Effect of chlorhexidine bathing on reducing ventilatorassociated pneumonia in patients in neurosurgical intensive care unit

摘要:

目的评价氯己定擦浴降低呼吸机相关肺炎(VAP)的效果。方法对某院神经外科重症监护病房（ICU）机械通气>48 h患者进行干预，采用氯己定皮肤擦浴，1次/日，并建立有效监督管理机制，比较干预前（2013年1—12月）和干预后（第1阶段：2014年1—12月；第2阶段：2015年1—12月）VAP发生率。结果共调查1 015 例患者，干预前氯己定皮肤擦浴执行率为0，干预后第1、2阶段分别为 55.36%和88.49%；干预前VAP日发生率为9.21‰，干预后第1、2阶段分别为7.67‰、4.77‰，两组数据相关分析结果显示，VAP日发生率与干预措施执行率呈负相关关系(rs=-1.00, P<0.001)。结论氯己定擦浴可以有效降低VAP发生率。

Abstract:

ObjectiveTo evaluate the effect of chlorhexidine bathing on reducing ventilatorassociated pneumonia(VAP).MethodsPatients with mechanical ventilation for>48 hours in the neurosurgical intensive care unit(ICU) in a hospital were intervened, chlorhexidine skin rubbing was performed once a day, effective supervision and management mechanism was established, incidence of VAP before intervention (JanuaryDecember, 2013) and after intervention (first stage: JanuaryDecember, 2014; second stage: JanuaryDecember, 2015) was compared.ResultsA total of 1 015 patients were investigated, implementation rate of chlorhexidine skin rubbing before intervention was 0, the first and second stages of postintervention were 55.36% and 88.49% respectively. Incidence of VAP per 1 000 ventilator days before intervention was 9.21‰, the first and second stage after intervention were 7.67‰ and 4.77‰ respectively， correlation analysis on two groups of data showed that there was a negative correlation between incidence of VAP and implementation rate of intervention measures(rs=-1.00, P<0.001).ConclusionDaily bathing with chlorhexidine can effectively reduce the incidence of VAP.