CAJ | 학술논문

目的：探讨0.12%氯己定联合负压吸引式牙刷刷牙在经口气管插管机械通气患者口腔护理中的效果。方法采用抽签法随机分组原则将2012年10月-2013年11月在我科行气管插管机械通气治疗的70例患者分为观察组和对照组各35例，其中观察组有2例被剔除，实际为33例。两组均采用0.12%氯己定作为标准口腔护理液，观察组联合应用负压吸引式牙刷刷牙进行口腔护理，对照组采用传统的口腔擦拭法进行口腔护理，均4次/d，观察7 d。比较两组患者口腔护理前后口咽部细菌培养检出率、口腔护理后2h口腔异味及呼吸机相关性肺炎的发生率。结果观察组口咽部细菌培养检出率、口腔异味及呼吸机相关性肺炎的发生率均低于对照组（P<0.05），差异有统计学意义。结论经口气管插管机械通气患者采用0.12%氯己定联合负压吸引式牙刷刷牙能更好地减少口腔细菌定植，消除口腔异味，降低呼吸机相关性肺炎的发生率。
목적：탐토0.12%록기정연합부압흡인식아쇄쇄아재경구기관삽관궤계통기환자구강호리중적효과。방법채용추첨법수궤분조원칙장2012년10월-2013년11월재아과행기관삽관궤계통기치료적70례환자분위관찰조화대조조각35례，기중관찰조유2례피척제，실제위33례。량조균채용0.12%록기정작위표준구강호리액，관찰조연합응용부압흡인식아쇄쇄아진행구강호리，대조조채용전통적구강찰식법진행구강호리，균4차/d，관찰7 d。비교량조환자구강호리전후구인부세균배양검출솔、구강호리후2h구강이미급호흡궤상관성폐염적발생솔。결과관찰조구인부세균배양검출솔、구강이미급호흡궤상관성폐염적발생솔균저우대조조（P<0.05），차이유통계학의의。결론경구기관삽관궤계통기환자채용0.12%록기정연합부압흡인식아쇄쇄아능경호지감소구강세균정식，소제구강이미，강저호흡궤상관성폐염적발생솔。
Objective To explore the effect of 0.12% chlorhexidine with negative pressure suction toothbrush in patients with mechanical ventilation through orotracheal intubation. Methods Seventy patients undergoing mechanical ventilation through orotracheal intubation from October 2012 to November 2013 were randomly divided into observation group ( n=35, but 2 patients were removed) and control group (n=35). With 0.12%chlorhexidine as standard oral care solution, negative pressure toothbrush was applied in observation group for oral care while in control group traditional mouth scrubbing was used for 4 times/d for seven days. Oropharyngeal bacterial culture detection rate before and after oral care was compared and the incidence of oral odor two hours after oral care and ventilator-associated pneumonia (VAP) were recorded. Results The oropharyngeal bacterial culture detection rate and incidence of oral odor and VAP in observation group were lower than those in control group ( P<0.05). Conclusion 0.12%chlorhexidine with negative pressure suction toothbrush is beneficial to eliminating bad breath, reducing oropharyngeal bacterial propagation and the incidence of VAP for patients with mechanical ventilation through orotracheal intubation.