黄丽娟 巫玉婷 刘爱秀 辛艳红 吴敏

[摘要]目的 探討呼吸机管道湿化结合口腔护理对ICU呼吸机相关性肺炎（VAP）防范效果的影响。方法 选取2014年9月～2016年2月我院收治的112例进行机械通气的患者作为研究对象，采用随机数字表法将其分为对照组、研究组，每组 56例。对照组给予常规护理方案，研究组实施常规护理方法的同时给予呼吸机管道湿化结合口腔护理。比较两组患者的机械通气时间、住ICU时间、平均住院时间，呼吸机相关性肺炎发生率。结果 研究组患者的机械通气时间、住ICU时间、平均住院时间均短于对照组，差异有统计学意义（P<0.05）；对照组患者发生VAP 7例，发生率为12.50%。研究组患者发生VAP 1例，发生率为1.79%。研究组VAP发生率低于对照组，差异有统计学意义（χ2=4.846，P=0.028）。结论 对ICU患者实施呼吸机管道湿化结合口腔护理，可有效降低患者VAP发生率，缩短患者机械通气时间、住ICU时间及住院时间，临床应用价值高，值得推广应用。

[关键词]呼吸机；管道湿化；口腔护理；呼吸机相关性肺炎

[中图分类号] R473.5 [文献标识码] A [文章编号] 1674-4721（2018）4（b）-0192-03

On the Effects of the Joint Implementation of Ventilator Pipeline Humidification and Mouth Cavity Nursing in the Prevention of Ventilator-related Pneumonia

HUANG Li-juan1 WU Yu-ting2 LIU Ai-xiu1 XIN Yan-hong3 WU Min4

1.Intensive Care Unit，the Second People′s Hospital of Yichun City in Jiangxi Province，Yichun 336000，China；2.Department of Nursing，the Second People′s Hospital of Yichun City，in Jiangxi Province，Yichun 336000，China；3.Department of Rehabilitation，the Second People′s Hospital of Yichun City in Jiangxi Province，Yichun 336000，China；4.Department of Science and Education，the Second People′s Hospital of Yichun City in Jiangxi Province，Yichun 336000，China

[Abstract]Objective To investigate the effect of ventilator-associated pneumonia （VAP） prevention in ICU by ventilator tube humidification combined with oral care.Methods A total of 112 patients with mechanical ventilation admitted to our hospital from September 2014 to February 2016 were selected as the research objects，and randomly divided into control group and study group，with 56 cases in each group.The control group was given routine nursing plan，the study group was given ventilator tube humidification combined with oral care at the same time of routine nursing.The duration of mechanical ventilation，ICU stay，average hospital stay and the incidence of VAP were compared between the two groups.Results The duration of mechanical ventilation，ICU stay and average hospital stay in the study group were shorter than those in the control group （P<0.05）.VAP occurred in 7 patients （12.50%） in the control group.VAP occurred in 1 patient（1.79%） in the study group.The incidence of VAP in the study group was significantly lower than that in the control group （χ2=4.846，P=0.028）.Conclusion The joint implementation of ventilator pipeline humidification and mouth cavity nursing for patients in ICU can effectively reduce the occurrence of VAP，shorten the time of mechanical ventilation，ICU staying and hospitalization.It is high clinically valuable and is worthy of wide application.

[Key words]Ventilator；Pipeline humidification；Mouth cavity nursing；Ventilator-related pneumonia

呼吸机相关性肺炎（ventilator associated pneumonia，VAP）是指患者接受机械通气治疗48 h后和停用机械通气后48 h内发生的肺炎，是ICU进行机械通气患者常见的并发症之一，其发病率为9%～70%，病死率为20%～70%[1-2]。机械通气患者由于建立人工气道的原因，使患者口腔内分泌物聚集，易引起病原微生物大量繁殖，导致发生呼吸机相关性肺炎[3]。本文旨在探讨呼吸机管道湿化结合口腔护理对ICU呼吸机相关性肺炎防范效果的影响，现报道如下。

1 资料与方法

1.1 一般资料

选取2014年9月～2016年2月我院收治的112例进行机械通气的患者作为研究对象，采用随机数字表法将其分为对照组、研究组，每组 56例。对照组中，男33例，女23例；年龄27～73岁，平均（42.34±3.74）岁；基础疾病类型：呼吸系统疾病21例，神经系统疾病17例，外科手术后11例，外伤7例。研究组中，男32例，女24例；……