沈周平　陈　倩　陈　晔

1.杭州市中医院呼吸科，浙江杭州　310007；2.浙江省新华医院呼吸科，浙江杭州　310004

康复新液口腔护理对慢性阻塞性肺疾病急性加重期患者内源性感染的影响

沈周平1陈倩1陈晔2

1.杭州市中医院呼吸科，浙江杭州310007；2.浙江省新华医院呼吸科，浙江杭州310004

目的观察慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）急性加重期患者应用康复新口腔护理预防内源性感染的临床疗效。 方法选择2014年12月～2015年1月间在我院住院的118例COPD急性加重期患者，按分层随机分为实验组60例和对照组58例，两组患者均给予一般治疗，实验组给予康复新液口腔护理，对照组给予生理盐水口腔护理，比较两组患者口腔护理前后的口腔一般情况、医院获得性肺炎（hospitalacquired pneumonia，HAP）的发生率、口腔真菌感染的发生率、患者的舒适度、并发症和预后。结果两组患者给予口腔护理后口腔异味［（2.60±1.01）和（2.83±1.19）vs（3.97±1.46）和（3.93±1.41），P＜0.05）］及口腔pH值［（6.39± 0.21）和（5.94±0.21）vs（5.59±0.22）和（5.58±0.21）］均较治疗前有好转。实验组在改善患者口腔异味、pH值以及口腔真菌感染率、HAP发生率、并发症方面均优于对照组［口腔异味差值为（1.37±0.69）vs（1.10±0.45），pH差值为（-0.80±0.31）vs（-0.35±0.15），口腔真菌感染率8.33%vs 25.86%，HAP发生率20.00%vs 37.93%，并发症5.00%vs 43.10%，P＜0.05］。两组患者舒适度比较无明显差异（81.67%vs 82.76%，P＞0.05）。结论应用康复新口腔护理可以预防COPD急性加重期患者内源性感染的发生率，值得进一步推广。

慢性阻塞性肺疾病；急性加重期；口腔护理；内源性感染；康复新液；医院获得性肺炎

［Abstract］Objective To observe the clinical efficacy of kangfuxin solution oral care on endogenous infection in patients with acute exacerbation of chronic obstructive pulmonary disease（COPD）.M ethods 118 patients with acute exacerbation of COPD treated in our hospital from December 2014 to January 2015 were selected and randomly divided into study group（60 cases）and control group（58 cases）.Patients in both groupswere given general treatment，and those in the study group were additionally given Kangfuxun solution oral care，while patients in control group were additionally given normal saline（NS）oral care.The general oral conditions of patients，incidence rates of hospitalacquired pneumonia（HAP），incidence rates of oral fungal infection，and comfort level，complications，and outcomes of patients were compared before and after treatment between two groups.Results After routine oral care，the degrees of bad breath（2.60±1.01 and 2.83±1.19 vs 3.97±1.46 and 3.93±1.41，P＜0.05）and oral pH values（6.39±0.21 and 5.94± 0.21 vs 5.59±0.22 and 5.58±0.21）were improved in both group than before treatment.The improvement of bad breath，pH values，rate of oral fungal infection，incidence of HAP and complications in the study group were significantly superior to those in the control group（changes of bad breath degree:1.37±0.69 vs1.10±0.45；change of pH values:-0.80± 0.31 vs-0.35±0.15；rate of oral fungal infection:8.33%vs 25.86%；incidence of HAP:20.00%vs 37.93%；and incidence of complications:5.00%vs 43.10%，P＜0.05）.There was no significant difference in comfort level between two groups（81.67%vs 82.76%，P＞0.05）.Conclusion Application of kangfuxin solution oral care can reduce the incidence of endogenous infection in patientswith acute exacerbation of COPD and isworthy to be further promoted.

［Key words］Chronic obstructive pulmonary disease；Acute exacerbation；Oral care；Endogenous infection；Kangfuxin solution；Hospital-acquired pneumonia

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）按病程可以分为稳定期和急性加重期，而目前研究证实引起COPD急性加重最常见的原因是呼吸道感染［1］。同时，感染也是导致急性加重期患者并发呼吸衰竭、延长住院时间、延长机械通气时间的主要原因［1］。……