内科理论与实践2013，Vol.8Issue(3)：204-208,5.DOI:10.3969/j.issn.1673-6087.2013.03.012
口腔护理液对重症患者院内获得性肺炎的影响
Impact of oral hygiene fluid on nosocomial pneumonia in critical ill patients
陈影 1杨之涛 1赵淑媛 1杨屹珺 1车在前 1朱琤 1周伟君 1钟鸣 1景峰1
作者信息
- 1. 上海交通大学医学院附属瑞金医院急诊科,上海200025
- 折叠
摘要
Abstract
Objective To investigate the impact of different oral hygiene fluid on nosocomial pneumoma (NP) and ventilation associated pneumonia (VAP) in critical ill patients in intensive care unit (ICU).Methods Patients admitted and stayed in ICU for more than 48 h from May 2008 to April 2012 were enrolled in the study.The oral hygiene in group M (212 patients) was provided by swabbing with 0.08％ metronidazole (MDE) twice daily,and in group C (661 patients) was provided by swabbing with 0.2％ chlorhexidine gluconate (CHX) twice daily.The incidence and time of occurring of NP and VAP,period of mechanical ventilation and bacterial isolation in sputum were studied.Results Of the patients in group M,61 episodes of NP (28.8％) occurred (21.1/1 000 hospitalized days) and the time of occurring of NP was (8.6±5.07) d,while in group C there were 118 episodes of NP (17.95％) (12.2/1 000 hospitalized days) and the time of occurring of NP was (11.3±8.4) d.There were 25 VAP (11.8％) (35.5/1 000 device-days) in group M,while in group C there were 49 VAP (7.4％) (16.8/1 000 device-days).The incidences of NP and VAP were significantly lower in group C than in group M (P＜0.05％),and NP occurred later in group C than in group M.There were no significant differences in sex,age,length of stay in ICU and acute physiology and chronic health evaluation (APACHE) Ⅱ score between the two groups.A.baumanii was the most frequently isolated bacteria for NP (28.1％) and VAP (31.0％),followed by P.aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA).Enterococcus spp.isolated was significantly lower in group C than in group M among NP patients (1.2％ vs.5.4％,P=0.043).Conclusions Oral hygiene with 0.2％ CHX twice daily reduced the incidence of NP and VAP among critical ill patients in ICU,suggested the benefit of oral hygiene with CHX for preventing NP and VAP in ICU patients.关键词
氯已定葡萄糖/重症监护病房/院内获得性肺炎/呼吸机相关性肺炎Key words
Chlorhexidine gluconate/Intensive care unit/Nosocomial pneumonia/Ventilator-associated pneumonia分类
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陈影,杨之涛,赵淑媛,杨屹珺,车在前,朱琤,周伟君,钟鸣,景峰..口腔护理液对重症患者院内获得性肺炎的影响[J].内科理论与实践,2013,8(3):204-208,5.
