改良式体位引流结合口腔清洁在预防呼吸机相关性肺炎中的可行性分析

摘要

Objective To investigate the application effect of modified postural drainage combined with oral hygiene in the prevention of ventilator-associated pneumonia.Methods 280 patients undergoing mechanical ventilation in ICU were randomly selected,in whom 140 cases underwent modified postural drainage and oral hygiene (study group),and the other 140 cases underwent traditional postural drainage and oral hygiene (control group).And then observed the clinical indicators of two groups,such as the time of mechanical ventilation,the incidence of stomatitis,the time of ICU,off-line success rate,the rate of pulmonary infection,the incidence of ventilator-associated pneumonia,and the mortality rate.Results The time of mechanical ventilation and ICU of study group were significantly shorter than those of control group,with statistically significant differences (P＜0.05).The off-line success rate of study group (93.6％) was significantly higher than that of control group,with statistically significant difference (P＜0.05).The rate of pulmonary inflection of study group was lower than that of control group,with statistically significant difference (P＜0.05).There was no statistically significant difference in the rate of stomatitis between two groups (P＞0.05).The incidence of VAP and mortality rate in study group were 6.4％ and 3.6％,those in control group were 24.3％ and 12.1％,with statistically significant differences between two groups (P＜0.05).Conclusions Modified postural drainage combined with oral hygiene can effectively improve the clinical symptoms of mechanical ventilation patients,reduce the incidence of ventilator-associated pneumonia.Therefore,it is feasible to apply modified postural drainage combined with oral hygiene in the prevention of ventilator-associated pneumonia,worthy of clinical application.%目的 探究改良式体位引流配合口腔清洁在预防呼吸机相关性肺炎中的应用效果.方法 随机选取280例ICU机械通气患者,其中140例采用改良式体位引流与口腔清洁护理为研究组,140例采用常规体位引流与口腔清洁护理为对照组,观察两组患者机械通气时间、口腔炎症发生率、ICU时间、脱机成功率、肺部感染率、呼吸机相关性肺炎发生率以及病死率等临床指标.结果 研究组患者机械通气时间与ICU时间均明显短于对照组,差异有统计学意义(P＜0.05);研究组患者脱机成功率为93.6％,明显高于对照组,差异有统计学意义(P＜0.05);研究组患者肺部感染率低于对照组,差异有统计学意义(P＜0.05);两组患者的口腔炎症率则无统计学差异(P＞0.05).研究组患者VAP发生率为6.4％,病死率为3.6％;对照组VAP发生率为24.3％,病死率为12.1％,两组相比差异有统计学意义(P(0.05).结论 采用改良式体位引流配合口腔清洁护理,能够有效改善ICU机械通气患者的临床症状,降低呼吸机相关性肺炎发生率,因此应用改良式体位引流结合口腔清洁预防呼吸机相关性肺炎切实可行,值得临床推广应用.