叶晓英++++++郑晓芳++++++艾芳芳++++++佘纪岚++++++徐淑娟++++++王胜莉

[摘要]目的 探讨含漱消毒液口腔护理在呼吸机相关性肺炎（VAP）患者中的应用效果。方法 选择2015年12月～2017年1月我院收治的120例行气管插管机械通气患者为研究对象，根据不同的口腔护理方式，随机分为试验组和对照组，每组各69例。对照组给予常规口腔护理，试验组给予含漱消毒液口腔护理。分析两组患者口腔疾患发生情况，比较两组患者VAP发生率和两组VAP患者护理前后口腔细菌培养结果。结果 试验组患者口腔异味、口腔溃疡、口腔血痂发生率均低于对照组，但口腔异味和口腔血痂发生率差异无统计学意义（P>0.05）；两组患者口腔溃疡发生率差异有统计学意义（P<0.05）。对照组VAP发生率为30.00%，高于试验组的8.33%（P<0.05）。護理后，试验组患者各菌群菌株数均明显低于对照组，两组患者口腔细菌培养结果差异有统计学意义（P<0.05）。结论 含漱消毒液口腔护理可减少气管插管患者口腔疾患的发生，降低VAP发生率，改善口腔菌群。

[关键词]含漱消毒液；口腔护理；呼吸机相关性肺炎；应用效果

[中图分类号] R563.1 [文献标识码] A [文章编号] 1674-4721（2017）11（c）-0151-03

The application effect of gargle disinfection liquid oral care in patients with ventilator associated pneumonia

YE Xiao-ying ZHENG Xiao-fang AI Fang-fang SHE Ji-lan XU Shu-juan WANG Sheng-li

Department of ICU，the People′s Hospital of Yingtan City，Jiangxi Province，Yingtan 335000，China

[Abstract]Objective To explore the application effect of gargle disinfection liquid oral care in patients with ventilator associated pneumonia（VAP）.Methods 120 cases of tracheal intubation mechanical ventilation in our hospital from December 2015 to January 2017 were selected as the research object.According to different oral care methods，they were randomly divided into experimental group and control group，60 cases in each group.The control group received conventional oral care，the experimental group was given oral care gargle disinfection solution.The incidence of oral diseases in two groups was analyzed.The incidence of VAP in two groups and the results of oral bacterial culture before and after nursing in two groups of patients with VAP were compared.Results The results of the experimental group of patients with oral odor，oral ulcers，oral blood scab incidence was lower than the control group，two groups of patients with halitosis and oral blood scab there was no significant difference between them（P>0.05）；two groups of patients with oral ulcer incidence rate difference was statistically significant（P<0.05）.The incidence of VAP in the control group was 30.00%，which was higher than that of 8.33% in the experimental group（P<0.05）.After nursing，patients in the experimental group the bacteria strains were significantly lower than the control group，two groups of patients with oral bacterial culture results had significant difference（P<0.05）.Conclusion Gargle disinfection liquid oral care can reduce the incidence of tracheal intubation in patients with oral disease，reduce the incidence of VAP and improve the oral flora.

[Key words]Gargle disinfection liquid；Oral nursing；Ventilator-associated pneumonia；Correlation；Application effectendprint

呼吸机相关性肺炎（VAP）是气管插管患者常见并发症之一。临床研究显示[1-2]，气管插管患者在接受机械通气时，气管中的天然保护屏障遭到严重破坏，加之疾病治疗过程中各种药物的服用，患者口腔黏膜干燥，唾液分泌不足，口腔的自我净化功能和局部黏膜的抵抗力大大减弱，造成大量的口腔细菌的繁殖。气管插管患者一般通气时间较长，病情严重，免疫力严重下降，均增加了口腔感染程度。因此，气管插管患者的口腔护理要求较高。口腔护理的目的在于保持患者口腔卫生，减少菌群的繁殖，降低VAP的发生率[3-4]。而临床上由于护理人员对口腔护理重要性认识欠缺，加上气管插管的干扰，传统的擦拭法难以达到口腔护理效果。本文……