不同浓度氯己定口腔护理液对机械通气病人抑菌效果及呼吸机相关性肺炎防治效果研究

摘要

[目的]探讨不同浓度氯己定口腔护理液对机械通气病人的抑菌效果以及呼吸机相关性肺炎 (VAP) 的防治效果.[方法]采用随机数字表法将120例机械通气治疗病人随机分为3组各40例, 对照组采用生理盐水进行口腔护理, 低浓度氯己定组应用0.12％的氯己定进行口腔护理, 高浓度氯己定组应用2％氯己定进行口腔护理.7d后比较口腔护理效果, 记录3组受试者VAP发生情况、机械通气时间、入住ICU时间、住院时间以及死亡情况并进行比较.[结果]干预7d后, 3组受试者细菌阳性率、菌落数、牙菌斑指数、VAP发生率、机械通气时间、入住ICU时间、住院时间比较差异均有统计学意义 (P<0.05) .[结论]机械通气病人口腔护理中应用氯己定溶液有利于提高抑菌效果, 缩短住院时间, 降低VAP发生率, 且0.12％浓度的氯己定溶液效果更优.%Objective:To explore the bacteriostasis effect of different concentrations of chlorhexidine oral nursing solution on mechanical ventilation patients and the prevention and treatment effect for ventilator associated pneumonia (VAP) .Methods:A total of 120 patients with mechanical ventilation were randomly divided into 3 groups by random number method.The patients in control group were treated with normal saline for oral nursing.The patients in low concentration of chlorhexidine group were treated with 0.12％of chlorhexidine in oral nursing, and 2％ of chlorhexidine was used in oral nursing in the high concentration of chlorhexidine group.After 7 d, the effect of oral nursing was compared, and the incidence of VAP, mechanical ventilation time, ICU time, hospitalization and death were recorde and compared among the 3 groups.Results:After 7 dintervention, the positive rate of bacteria, the number of colonies, the plaque index, the incidence of VAP, the time of admitting mechanical ventilation, the time of admitting ICU and the time of hospitalization among the 3 groups were statistically significant (P<0.05) .Conclusions:The application of chlorhexidine solution in the oral nursing of mechanical ventilation patients could improve the bacteriostasis effect, shorten the time of hospitalization, reduce the incidence of VAP, and the 0.12％chlorhexidine solution is more effective.