不同频率复方氯己定含漱液口腔护理在机械通气患者中的应用效果比较

摘要

Objective To compare the application effect of the different frequency of compound chlorhexidine gargle in oral nursing of patient with mechanical ventilation. Methods 154 cases accepted mechanical ventilation for more than 48 hours from January 2012 to December 2013 in our hospital were selected and randomly divided into the observation group(112 cases) and the control group(42 cases).The control group was given oral nursing with normal saline, four times a day.The observation group was given compound chlorhexidine gargle for oral nursing.The observation group was fur-ther divided into three groups.Group 1 of 36 cases was given oral nursing twice a day,group 2 of 38 cases three times a day,group 3 of 38 cases four times a day.The effect of the different frequency of compound chlorhexidine gargle in oral nursing in two groups was compared. Results The incidence rate of VAP infection,mechanical ventilation time,length of hospital stay and cost of hospitalization in the observation group,the observation group 2 and the observation group 3 was lower than that in the control group,with significant difference (P<0.05).The incidence rate of halitosisand and oral inflammation in the observation group,the observation group 2 and the observation group 3 was lower than that in the control group,with significant difference(P<0.05). The incidence rate of thin tongue coating in the observation group,the observation group 2 and the observation group was higher than that in the control group,with significant difference (P<0.05). Conclusion The application of compound chlorhexidine oral nursing three times a day can significantly de-crease the incidence of VAP and oral complication,it is worthy of clinical promotion and application.%目的：比较不同频率复方氯己定含漱液在机械通气患者中的应用效果。方法选取2012年1月~2013年12月本院收治的154例机械通气时间>48 h的患者作为研究对象，随机分为观察组(112例)和对照组(42例)。对照组使用生理盐水口腔护理，4次/d；观察组使用复方氯己定含漱液口腔护理。观察组又随机分为3组，观察1组(36例)给予口腔护理，2次/d；观察2组(38例)给予口腔护理，3次/d；观察3组(38例)给予口腔护理，4次/d。比较不同频率复方氯己定含漱液口腔护理的效果。结果观察组、观察2组与观察3组的VAP感染率、机械通气天数、住院天数及住院费用显著低于对照组，差异有统计学意义(P<0.05)。观察组、观察2组与观察3组的口臭、口腔炎症发生率显著低于对照组，差异有统计学意义(P<0.05)。观察组、观察2组及观察3组的舌苔转薄发生率显著高于对照组，差异有统计学意义(P<0.05)。结论3次/d使用复方氯己定含漱液进行口腔护理，可显著降低VAP及口腔并发症发生率，值得临床推广使用。