不同口腔护理时机对呼吸机相关肺炎护理效果的影响研究

摘要

Objective To explore the impact of different timing of oral care on nursing efficacy of ventilator-associated pneumonia.Methods A total of 129 critically ill patients during mechanical ventilation were randomly divided into group A,group B and control group,with 40 cases per group.The control group was treated with routine oral care every 12 h,A group for eight hours,group B for five hours.Early,delayed and overall incidence of VAP were compared in three groups,VAP occurrence time,the incidence of oral complications were observed,and mechanical ventilation,length of hospital stay and mortality were compared.Results After nursing intervention,early,delayed and overall incidence of VAP of group A and group B were significantly lower than that of the control group (P ＜ 0.05),but VAP time between A group and B showed no significant differences (P ＞ 0.05);The occurrence of complications in A group were significantly better than that of the control group(P ＜0.05).Duration of mechanical ventilation,length of stay and mortality of B group were shorter than A group and control group (P ＜ 0.05),above three indicators of group A were significantly lower than that of the control group (P ＜ 0.05).Conclusion Effects of oral care timing of ventilator-associated pneumonia care are different,the three nursing methods can shorten oral care cycle time,significantly improve nursing effect of ventilator-associated pneumonia,but 5 h oral care has the best nursing efficacy,and it is worthy of clinical practice.%目的 探讨不同口腔护理时机对呼吸机相关肺炎护理效果的影响.方法 选择接受机械通气的120例危重患者,随机分为A组、B组、对照组.对照组患者给予每12h1次的常规口腔护理,A组患者实施8h1次的口腔护理,B组患者行5h1次的口腔护理.观察3组患者干预后早期、延期及总VAP发生率,比较3组患者VAP发生时间、口腔并发症发生率,分析3者患者机械通气时间、住院时间以及病死率.结果 经过护理干预,A组与B组患者的早期VAP发生率、延期VAP发生率及总VAP发生率均显著低于对照组(P＜0.05),A组与B组患者之间的以上3项指标差异不显著(P＞0.05);A组与B组患者的VAP发生时间及各种并发症的发生率均显著优于对照组,差异具有统计学意义(P＜0.05).A组与B组患者的VAP发生时间差异不显著(P＞0.05),但A组患者的并发症的发生率高于B组(P＜0.05);B组患者的机械通气时间、住院时间以及病死率均显著低于A组患者与对照组患者,差异具有统计学意义(P＜0.05),A组患者的以上3项指标均显著低于对照组,差异具有统计学意义(P＜0.05).结论 不同口腔护理时机对呼吸机相关肺炎护理效果不同,能够缩短口腔护理周期时间,显著改善呼吸机相关肺炎护理效果,5h1次的口腔护理对呼吸机相关肺炎护理效果影响最大,值得在临床推广.