Objective To select oropharyngeal decontamination for orotracheal intubation patients with pre-gener-al anesthesia to decrease oropharyngeal bacterial adhesions,and to study the feasibility of oropharyngeal decontami-nation. Method 250 patients were randomly divided into five groups (n=50). All patients were administrated selec-tive oropharyngeal decontamination before 30 minutes of orotracheal intubation. No selective oropharyngeal decon-tamination in control group was used and normal tooth brushing, Sodium chloride,0. 1% , PVP-I, 0. 12% Chlorhex-idine gluconate were used in experimental groups. Collected oropharyngeal specimens before, after and 4 hours after mechanical ventilation for bacterial culture. Result Group D and group E Gram-negative bacillus and Gram-negative diplococci wao decreased (P<0. 05). Decreasing level of four experimental groups in Gram-positive streptococcus, Gram-positive staphylococci and eumycete was no significant difference. 0. 12% Chlorhexidine gluconate group had significant difference in inhibiting Gram-negative bacillus (P<0. 05). Conclusion 0. 12% Chlorhexidine gluconate and 0.1% PVP-I could reduce Gram-negative bacillus and Gram-negative diplococci in oropharynx for general Anesthsia patient. Normal tooth brushing and sodium chloride only can clean oral cavity, but not sterilize. 0. 12% chlorhexi-dine gluconate group could inhibit the growth of Gram-negative bacillus.%目的 探讨经口气管插管的全身麻醉患者在气管插管前口咽去污染的临床意义.方法 250例患者随机分为5组,每组50例,A组为对照组,不进行任何干预,其余四组在气管插管前30 min予口咽去污染,其中实验B组进行常规刷牙,实验C组、实验D组、实验E组分别用生理盐水、0.1％的聚维酮碘及0.12％的醋酸氯己定口咽含漱.采集口咽去污染前、气管插管后、机械通气后4h的口咽部标本进行细菌培养及菌种分型.结果 D组与E组口咽去污染后可以减少革兰氏阴性杆菌、革兰氏阴性双球菌(P＜0.05).4个实验组虽然可以部分减少革兰氏阳性链球菌、革兰氏阳性葡萄球菌、真菌,但减少程度比较差异无显著意义(P＞0.05).E组有抑制革兰氏阴性杆菌生长的作用(P＜0.05).结论 聚维酮碘、醋酸氯已定含漱能够减少革兰氏阴性杆菌、革兰氏阴性双球菌在全麻患者口咽部的定植.常规刷牙及生理盐水口咽含漱仅对口咽有清洁作用,不能杀灭口咽常见细菌.醋酸氯己定对革兰氏阴性杆菌生长有一定抑制作用.
展开▼
