中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
CHINESE JOURNAL OF INFECTION CONTROL
2014年
7期
396-398,424
,共4页
选择性口咽去污染%呼吸机相关性肺炎%妥布霉素%医院感染
選擇性口嚥去汙染%呼吸機相關性肺炎%妥佈黴素%醫院感染
선택성구인거오염%호흡궤상관성폐염%타포매소%의원감염
selective oral decontamination%ventilator-associated pneumonia%tobramycin%healthcare-associated in-fection
目的：观察口咽去污染对降低机械通气患者呼吸机相关性肺炎（VAP）发病率的意义。方法选择某院2012年1-6月入住重症监护室（ICU）内72 h 以上且机械通气时间超过48 h 的患者60例，随机分为实验组和对照组各30例。所有入选病例均给予静脉滴注头孢噻肟4 d，实验组机械通气全程用妥布霉素局部滴入口咽部，对照组用生理盐水局部滴入，记录两组患者发生 VAP 的病例数、发病时间及机械通气时间、ICU 住院时间、病死率。定期留取气管内痰液进行细菌培养。结果实验组 VAP 的发病率为30．00％，明显低于对照组的63．33％；VAP 的发病时间为（9．37±6．62）d，迟于对照组的（5．17±4．72）d；总机械通气时间为（7．63±6．91）d，低于对照组的（12．26±9．36）d；住 ICU 时间为（13．56±7．22）d，低于对照组的（16．79±11．16）d；上述项两组比较，均 P ＜0．05。两组病死率比较，差异无统计学意义（P ＞0．05）。结论口咽去污染是防治 VAP 的有效方法，能有效降低VAP 发生率，使 VAP 发病时间延迟，并减少机械通气时间及入住 ICU 时间。
目的：觀察口嚥去汙染對降低機械通氣患者呼吸機相關性肺炎（VAP）髮病率的意義。方法選擇某院2012年1-6月入住重癥鑑護室（ICU）內72 h 以上且機械通氣時間超過48 h 的患者60例，隨機分為實驗組和對照組各30例。所有入選病例均給予靜脈滴註頭孢噻肟4 d，實驗組機械通氣全程用妥佈黴素跼部滴入口嚥部，對照組用生理鹽水跼部滴入，記錄兩組患者髮生 VAP 的病例數、髮病時間及機械通氣時間、ICU 住院時間、病死率。定期留取氣管內痰液進行細菌培養。結果實驗組 VAP 的髮病率為30．00％，明顯低于對照組的63．33％；VAP 的髮病時間為（9．37±6．62）d，遲于對照組的（5．17±4．72）d；總機械通氣時間為（7．63±6．91）d，低于對照組的（12．26±9．36）d；住 ICU 時間為（13．56±7．22）d，低于對照組的（16．79±11．16）d；上述項兩組比較，均 P ＜0．05。兩組病死率比較，差異無統計學意義（P ＞0．05）。結論口嚥去汙染是防治 VAP 的有效方法，能有效降低VAP 髮生率，使 VAP 髮病時間延遲，併減少機械通氣時間及入住 ICU 時間。
목적：관찰구인거오염대강저궤계통기환자호흡궤상관성폐염（VAP）발병솔적의의。방법선택모원2012년1-6월입주중증감호실（ICU）내72 h 이상차궤계통기시간초과48 h 적환자60례，수궤분위실험조화대조조각30례。소유입선병례균급여정맥적주두포새우4 d，실험조궤계통기전정용타포매소국부적입구인부，대조조용생리염수국부적입，기록량조환자발생 VAP 적병례수、발병시간급궤계통기시간、ICU 주원시간、병사솔。정기류취기관내담액진행세균배양。결과실험조 VAP 적발병솔위30．00％，명현저우대조조적63．33％；VAP 적발병시간위（9．37±6．62）d，지우대조조적（5．17±4．72）d；총궤계통기시간위（7．63±6．91）d，저우대조조적（12．26±9．36）d；주 ICU 시간위（13．56±7．22）d，저우대조조적（16．79±11．16）d；상술항량조비교，균 P ＜0．05。량조병사솔비교，차이무통계학의의（P ＞0．05）。결론구인거오염시방치 VAP 적유효방법，능유효강저VAP 발생솔，사 VAP 발병시간연지，병감소궤계통기시간급입주 ICU 시간。
Objective To evaluate the effect of selective oral decontamination (SOD)on reducing incidence of ventilator-associated pneumonia (VAP).Methods Sixty patients hospitalized in an intensive care unit (ICU)for >72 hours and with mechanical ventilation for >48 hours from January to June 2102 were selected for study,patients were ran-domly divided into trial group(n =30)and control group(n=30).All patients received cefotaxime intravenous drip for 4 days,then trial group received oropharyngeal application of tobramycin during the whole process of mechanical ventila-tion,control group topically received saline solution,the incidence and onset time of VAP ,duration of mechanical ventila-tion,length of stay in ICU,and mortality of two groups were compared.Sputum in the trachea was taken periodically for bacterial culture.Results The incidence of VAP in trial group was lower than control group (30.00% vs 63.33%);the onset time of VAP was later than control group ([9.37±6.62]d vs [5.17 ±4.72]d);Overall duration of me-chanical ventilation was less than control group ([7.63 ±6.91 ]d vs [12.26 ±9.36]d);length of stay in ICU was shorter than control group([13.56±7.22]d vs [16.79±11 .16]d)(all P <0.05).There were no significant differ-ence in mortality between two groups(P >0.05).Conclusion SOD is effective for preventing and treating VAP,it can reduce the incidence of VAP,delay onset time of VAP,shorten mechanical ventilation,and reduce length of stay in ICU.
