CAJ | 학술논문

目的：比较牙刷+冲洗法与棉球擦拭法用于经口气管插管患者口腔护理的效果。方法根据研究目的确定检索关键词，采用计算机检索国内外大型数据库，同时追踪文献综述和参考文献以防漏检。根据文献纳入、排除标准对检出文献进行筛选，确定最终纳入文献。对纳入文献按Cochrance协作网提供的Meta分析对其进行定量综合分析，比较2种不同口腔护理方法的护理效果。结果共21篇文献2494例患者符合纳入标准，牙刷+冲洗法组呼吸机相关性肺炎发生率较棉球擦拭法组低，合并RR值为0.49，95%CI为（0.39，0.62）；牙刷+冲洗法组口腔异味发生率较棉球擦拭法组低，合并RR值为0.29，95%CI为（0.21，0.41）；牙刷+冲洗法组口腔溃疡发生率较棉球擦拭法组低，合并RR值为0.40，95%CI为（0.29，0.57）；牙菌斑指数存在异质性（P＜0.001），亚组分析均显示牙刷+冲洗法组牙菌斑指数较棉球擦拭法组少；机械通气时间在使用牙刷+冲洗法与使用棉球擦拭法进行口腔护理的患者间的差异无统计学意义（P=0.15），合并WMD的值为-1.02，95%CI为(-2.41，0.37）。结论牙刷+冲洗法较棉球擦拭法对经口气管插管患者口腔护理的效果好，但对机械通气时间的影响不能确定。
목적：비교아쇄+충세법여면구찰식법용우경구기관삽관환자구강호리적효과。방법근거연구목적학정검색관건사，채용계산궤검색국내외대형수거고，동시추종문헌종술화삼고문헌이방루검。근거문헌납입、배제표준대검출문헌진행사선，학정최종납입문헌。대납입문헌안Cochrance협작망제공적Meta분석대기진행정량종합분석，비교2충불동구강호리방법적호리효과。결과공21편문헌2494례환자부합납입표준，아쇄+충세법조호흡궤상관성폐염발생솔교면구찰식법조저，합병RR치위0.49，95%CI위（0.39，0.62）；아쇄+충세법조구강이미발생솔교면구찰식법조저，합병RR치위0.29，95%CI위（0.21，0.41）；아쇄+충세법조구강궤양발생솔교면구찰식법조저，합병RR치위0.40，95%CI위（0.29，0.57）；아균반지수존재이질성（P＜0.001），아조분석균현시아쇄+충세법조아균반지수교면구찰식법조소；궤계통기시간재사용아쇄+충세법여사용면구찰식법진행구강호리적환자간적차이무통계학의의（P=0.15），합병WMD적치위-1.02，95%CI위(-2.41，0.37）。결론아쇄+충세법교면구찰식법대경구기관삽관환자구강호리적효과호，단대궤계통기시간적영향불능학정。
Objective To compare the different effects of toothbrush-irrigation and wiping with cotton ball for oral care of orotracheal intubation patients. Methods Computer retrieval was conducted in large databases at home and abroad, meanwhile literature review and references were tracked for undetected literatures. According to the inclusion and exclusion criteria, the included studies were determined then Meta analysis was carried out for comprehensive and quantitative analysis for different effects of oral care methods. Results Totally 21 studies (2 494 patients) were included for Meta-analysis. The incidence of VAP [Combined RR=0.49, 95% CI (0.39, 0.62)], bad breath [Combined RR=0.29, 95% CI (0.21,0.41)] and oral ulcers [Combined RR=0.40, 95%CI (0.29,0.57)] in patients with toothbrush-irrigation was lower than those wiping with cotton ball. The difference in the amount of plaque index in patients with toothbrush-irrigation and those wiping with cotton ball was statistically significant ( P<0.001). Subgroup analysis suggested that there was less amount of plaque index in patients with toothbrush-irrigation than those wiping with cotton ball. The difference in the duration of mechanical ventilation in patients with toothbrush-irrigation and in those wiping with cotton ball was not statistically significant [P=0.15, Combined WMD:-1.02, 95%CI (-2.41,0.37)]. Conclusion The effect of toothbrush-irrigation is better than wiping with cotton ball for orotracheal intubation patients.