CAJ | 학술논문

目的探讨过氧化氢对经口气管插管患者预防感染性并发症的效果.方法将90例经口气管插管机械通气患者随机分为A、B、C三组,每组各30例.A组患者采用3％过氧化氢溶液棉球擦洗联合0.9％氯化钠溶液冲洗口腔；B组采用0.9％氯化钠溶液冲洗口腔；C组按常规采用0.9％氯化钠溶液棉球进行口腔擦洗,均每日2次.观察三组患者口咽部细菌数、口腔pH值和清洁度及口腔感染的发生率.结果三种方法护理口腔后,A、B、C三组口咽部细菌数均减少[分别为(306.70±15.57),(436.10±19.14),(762.33±28.46) cfu/平皿；F=116.5；P＜0.05],以A组最明显；三组方法护理后患者口腔pH值均升高[(6.70 ±0.085),(6.41 ±0.102),(6.35±0.076)],三组比较差异有统计学意义(F=4.415；P＜0.05),且以A组升高最明显；三组患者牙菌斑发生率(16.67％,40.00％,33.33％)及口腔感染发生率(10.00％,20.00％,33.33％)比较,差异无统计学意义(x2值分别为4.127,4.937；P＞0.05),三组患者口臭的发生率以A组最低(20.00％,43.33％,56.67％),三组比较差异有统计学意义(x2=8.61,P＜0.05).结论应用3％过氧化氢溶液棉球擦洗联合0.9％氯化钠溶液冲洗经口气管插管患者口腔预防感染性并发症效果较好.
목적 탐토과양화경대경구기관삽관환자예방감염성병발증적효과.방법 장90례경구기관삽관궤계통기환자수궤분위A、B、C삼조,매조각30례.A조환자채용3％과양화경용액면구찰세연합0.9％록화납용액충세구강；B조채용0.9％록화납용액충세구강；C조안상규채용0.9％록화납용액면구진행구강찰세,균매일2차.관찰삼조환자구인부세균수、구강pH치화청길도급구강감염적발생솔.결과 삼충방법호리구강후,A、B、C삼조구인부세균수균감소[분별위(306.70±15.57),(436.10±19.14),(762.33±28.46) cfu/평명；F=116.5；P＜0.05],이A조최명현；삼조방법호리후환자구강pH치균승고[(6.70 ±0.085),(6.41 ±0.102),(6.35±0.076)],삼조비교차이유통계학의의(F=4.415；P＜0.05),차이A조승고최명현；삼조환자아균반발생솔(16.67％,40.00％,33.33％)급구강감염발생솔(10.00％,20.00％,33.33％)비교,차이무통계학의의(x2치분별위4.127,4.937；P＞0.05),삼조환자구취적발생솔이A조최저(20.00％,43.33％,56.67％),삼조비교차이유통계학의의(x2=8.61,P＜0.05).결론 응용3％과양화경용액면구찰세연합0.9％록화납용액충세경구기관삽관환자구강예방감염성병발증효과교호.
Objective To explore the effect of hydrogen peroxide on the prevention of the infectious complication in the patients with orotracheal intubation.Methods Ninety patients with orotracheal intubation for mechanical ventilation were randomly divided into three groups,each with 30 cases.The oral cavities of the patients in Group A were washed with cotton balls soaked by 3％ hydrogen peroxide solution and rinsed with normal saline (0.9％ sodium chloride solution) ;those of the patients in Group B were rinsed with normal saline alone;and those of the patients in Group C were washed conventionally with cotton balls soaked by normal saline.The oral care was conducted twice daily in each group.The bacterial number in pharyngo-oral cavities,the pH values,clean degrees of oral cavities and the incidence of oral cavity infection in the three groups were observed.Results After oral care with the three methods,the bacterial number in pharyngo-oral cavities of the patients in Groups A,B and C were decreased,and respectively (306.70 ± 15.57),(436.10 ± 19.14),(762.33 ± 28.46) cfu/plate,the difference was statistically significant (F =116.5,P ＜ 0.05),and the decrease in bacterial number was most significant in Group A.The oral pH values of all the patients were increased,and were respectively (6.70 ± 0.085),(6.41 ± 0.102),(6.35 ± 0.076) in three groups,the difference was statistically significant (F=4.415,P＜0.05),and those of the patients in Group A were found to increase most significantly.The incidence of dental plaques (16.67％,40.00％,33.33％) and that of oral cavity infection (10.00％,20.00％,33.33％) did not show statistical significance (x2 =4.127,4.937,respectively; P ＞0.05).The incidence of halitosis (20.00％,43.33 ％,56.67％) showed significant differences (x2 =8.61,P ＜0.05),and the incidence of halitosis was lowest in Group A.Conclusions Washing the oral cavities with cotton balls soaked by 3％ hydrogen peroxide solution and rinsing the oral cavities with 0.9％ sodium chloride solution can prevent from the infectious complication in the patients with orotracheal intubation.