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目的探讨不同间隔时间口腔护理对呼吸机相关性肺炎(VAP)及并发症发生的影响。方法选取接受机械通气治疗的患者120例为研究对象,采用随机数字表法随机分为A组、B组、C组,每组40例。A组患者每隔4 h进行口腔护理一次,B组患者每隔8 h进行口腔护理一次,C组每隔12 h进行口腔护理一次。观察比较三组患者口腔霉菌感染、牙龈红肿出血、口腔溃疡、口臭发生情况;比较三组患者早发型、迟发型及总VAP发生情况以及三组患者机械通气时间、住院时间及住院病死率。结果 A组患者口腔霉菌感染、牙龈红肿出血、口臭发生率均显著低于C组(P<0.05);口腔溃疡发生率显著低于B组和C组(P<0.05)。A组患者迟发型VAP发生率显著低于C组(P<0.05);A组和B组患者VAP发生率显著低于C组(P<0.05)。A组患者机械通气时间、住院时间显著短于B组、C组(P<0.01),A组患者住院病死率显著低于C组(P<0.05);B组患者机械通气时间、住院时间显著短于C组(P<0.01)。结论缩短口腔护理间隔时间、增加口腔护理频次,能够显著提高护理效果,降低患者口腔并发症及VAP发生率,缩短患者机械通气治疗时间、住院时间,降低患者住院病死率。值得推广应用。
Objective To investigate the effects of oral care at different intervals on ventilator-associated pneumonia (VAP) and its complications. Methods A total of 120 patients undergoing mechanical ventilation were enrolled in this study. The patients were randomly divided into A group, B group and C group, with 40 cases in each group. Patients in group A received oral care every 4 hours, patients in group B received oral care every 8 hours and patients in group C received oral care every 12 hours. Oral mold infection, swollen gums, oral ulcers and halitosis were observed and compared in three groups. The occurrence of early, late and total VAP in the three groups were compared, and the duration of hospitalization, hospital stay and hospital mortality were compared between the three groups. Results The incidences of oral mold infection, swollen gums and halitosis in group A were significantly lower than those in group C (P <0.05). The incidence of oral ulcer was significantly lower than that in group B and C (P <0.05). The incidence of delayed type VAP in group A was significantly lower than that in group C (P <0.05). The incidence of VAP in group A and group B was significantly lower than that in group C (P <0.05). The duration of hospital stay and hospital stay in group A were significantly shorter than those in group B and C (P <0.01). The hospital mortality rate in group A was significantly lower than that in group C (P <0.05). The duration of mechanical ventilation and hospital stay in group B were significantly Shorter than C group (P <0.01). Conclusions Shortening the interval of oral care and increasing the frequency of oral care can significantly improve the nursing effect, reduce the incidence of oral complications and VAP, shorten the duration of mechanical ventilation and hospital stay, and reduce the in-hospital mortality. Worth promoting application.