三合一口腔冲洗法在重症监护室经口气管插管患者口腔护理中的应用

目的 探讨集冲、擦、洗于一体的三合一口腔冲洗法在重症监护室（ICU经口气管插管患者口腔护理中的应用效果。方法 采用便利抽样法选取2022年1—6月于十堰市太和医院ICU行经口气管插管的100例危重患者为研究对象,按照随机数字表法分为对照组和观察组,各50例。对照组采用常规口腔护理,观察组在对照组基础上采用三合一口腔冲洗法进行口腔护理。比较两组经口气管插管当天、插管后3 d和插管后5 d的口腔清洁效果（口腔异味及牙菌斑指数评分）及口腔并发症发生情况。结果 对照组插管后3、5 d的口腔异味及牙菌斑指数评分均高于插管当天,差异有统计学意义（P<0.05）;观察组插管后3、5 d的口腔异味及牙菌斑指数评分均低于插管当天,差异有统计学意义（P<0.05）;观察组插管后3、5 d的口腔异味及牙菌斑指数评分均低于对照组,差异有统计学意义（P<0.05）。观察组口腔并发症发生率低于对照组,差异有统计学意义（P<0.05）。结论 集冲、擦、洗于一体的三合一口腔冲洗法可有效提升ICU经口气管插管患者口腔清洁效果,降低口腔溃疡、口腔内黏膜出血等并发症发生风险。     

经口气管插管病人口腔护理方法研究

目的 探讨经口气管插管患者口腔护理的有效方法.方法 将56例经口气管插管患者随机分为两组,对照组按常规口腔护理操作方法,实验组在经过培训后采用刷牙及冲洗法进行口腔护理.观察并记录发生口臭、口腔感染、溃疡疱疹病例数.结果 实验组口臭率、口腔感染率及发生溃疡疱疹率明显低于对照组,差异有统计学意义.结论 口腔刷牙及冲洗法能提高经口气管插管患者口腔护理的质量,减少口臭、口腔感染并发症.     

经口气管插管两种不同口腔护理的效果观察体会

目的探讨甲硝唑溶液加碘伏擦洗及常规口腔护理对经口气管插管危重患者口腔护理的效果。方法将本组经口气管插管的44例患者,随机分成两组,试验组和对照组,对照组采用常规的口腔护理方法,试验组除在对照组口腔护理的基础上,选用甲硝唑溶液冲洗加0.5%碘伏擦洗法,两组进行口腔护理比较。结果试验组口臭发生率明显比对照组降低。结论经口气管插管选用甲硝唑溶液冲洗加0.5%碘伏擦洗进行口腔护理,对预防患者口臭和口腔炎症的发生,有显著的效果。     

经口气管插管病人两种口腔护理方法的临床研究

目的对经口气管插管患者行口腔冲洗和口腔擦拭两种口腔护理方法进行临床实践进行效果比较。方法选取我院从2010年1月—2011年1月份经口气管插管患者120例,将其随机平均分成两组,每组分60例,定义为实验组和对照组。其中,实验组利用口腔冲洗法进行临床研究,对照组则采用传统的口腔擦拭法进行临床研究。从口腔异味、咽拭子培养阳性率和黏膜溃烂破损三个方面分别比较两组口腔护理的最终效果。结果进行插管后第1天从口腔异味、咽拭子培养阳性率、黏膜溃烂破损三个方面进行比较,结果两组情况对照结果显示P>0.05,无显著性差异。此后每天进行一次结果对照,对病人进行插管后的第3天检测结果中发现,两组病人在口腔异味、咽拭子培养阳性率、黏膜溃烂破损三个方面比较结果显示P<0.05,P<0.01,有显著性差异。结论从两组临床试验得知,在经口气管插管患者的口腔护理中,口腔冲洗应用效果相对来说是更好的,在口腔异味、黏膜溃烂破损和咽拭子培养阳性率方面,传统的口腔擦拭法远远达不到口腔冲洗的效果,此外,口腔冲洗护理安全性高,操作简单方便。     

经口气管插管患者口腔护理中应用口腔冲洗加纱球擦洗法的效果观察

目的观察口腔冲洗加纱球擦洗法及传统口腔护理方法对经口气管插管患者口腔护理的效果,找出适合经口气管插管患者口腔护理的方法,以提高护理的质量。方法将146例经口气管插管患者随机分组,对照组70例患者采用传统口腔护理方法,试验组76例患者采用口腔冲洗加纱球擦洗法口腔护理,分别对两组患者进行口臭、口腔炎症发生率及呼吸机相关肺炎发生率进行对比研究。结果对照组口臭发生率为28．51％,口腔炎症发生率为22．85％;呼吸机相关怖炎发生率11．43％。试验组口臭发生率为5．26％,口腔炎症发生率为3．95％,呼吸机相关肺炎发生牢2．63％,两组数据的差异具有统计学意义。结论在经口气管插管患者的口腔护理中应用口腔冲洗加纱球擦洗对预防口臭和口腔炎症效果较好,在临床中应予以推广。     

小儿电动牙刷冲吸法在机械通气患者口腔护理中的临床应用

目的 探讨应用小儿电动牙刷冲吸法对机械通气患者进行口腔护理的临床效果.方法 将80例机械通气的重症患者按随机数字表法分为观察组和对照组,每组40例.观察组采用电动牙刷刷洗及冲吸球冲洗法进行口腔护理;对照组采用常规0.9％氯化钠棉球行口腔护理.结果 观察组治疗后牙菌斑、口腔异味、口腔残留物发生率及口腔细菌阳性率显著低于对照组[2.5(1/40)比32.5(13/40)、7.5％(3/40)比55.0(22/40)、0比20.0(8/40)、5.0(2/40)比45.0(18/40)],口腔pH值显著高于对照组(6.85±0.11比5.51±0.12),差异有统计学意义(P＜0.01).结论 对机械通气患者采用电动牙刷冲吸法进行口腔护理临床效果明显优于传统棉球擦洗法,是一项值得推广应用的临床护理新技术.     

改进经口气管插管患者口腔护理方法的研究

目的 改进口腔护理方法更有效地做好经口气管插管患者的口腔护理,积极预防和减少口腔并发症的发生.方法 将经口气管插管患者40例,随机分为对照组和实验组,每组各20例,对照组按传统口腔护理方法,实验组用冲洗法进行口腔护理.对两组患者口腔护理后的口臭发生率、口腔感染率方面进行对比研究.结果 实验组口臭发生率、口腔感染率低于对照组(p＜0.05).结论 改进后的口腔护理方法效果好,能彻底清洁口腔,有效地控制细菌感染,减少气管插管病人并发症的发生,值得临床推广.     

洗必泰口腔护理在经口气管插管患者中的应用

目的：探讨经口气管插管患者有效的口腔护理方法。方法：80例经口气管插管患者随机双盲分为观察组和对照组。观察组用洗必泰冲洗法进行口腔护理，对照组用0．9％氯化钠溶液法进行口腔护理。两组口腔护理操作方法相同。比较两组患者在口臭、口腔溃疡和呼吸机相关性肺炎（VAP）发生率的差异。结果：观察组和对照组在口臭、口腔溃疡和VAP发生率的比较，差异均有统计学意义（P〈0．05）。结论：经口气管插管患者的口腔护理洗必泰优于生理盐水。     

口腔灌洗法在经口气管插管患者口腔护理中的运用

目的探讨口腔灌洗法在经口气管插管患者口腔护理的效果。方法将经口气管插管需口腔护理的96例患者随机分为对照组和观察组,各48例,对照组按照传统口腔护理方法进行口腔护理,观察组采用口腔灌洗法,对两组的护理效果进行比较分析。结果观察组患者呼吸机相关性肺炎、口腔溃疡等情况发生率明显低于对照组,两组差异具有统计学意义(P值<0.05)。结论采用口腔灌洗法对经口气管插管患者进行口腔护理,能彻底清除口腔内的污垢,有效地控制细菌感染,降低患者口腔并发症的发生率,值得临床推广应用。     

口腔灌洗法在经口气管插管患者口腔护理中的运用

目的：探讨口腔灌洗法在经口气管插管患者口腔护理的效果。方法将经口气管插管需口腔护理的96例患者随机分为对照组和观察组,各48例,对照组按照传统口腔护理方法进行口腔护理,观察组采用口腔灌洗法,对两组的护理效果进行比较分析。结果观察组患者呼吸机相关性肺炎、口腔溃疡等情况发生率明显低于对照组,两组差异具有统计学意义（P值＜0.05）。结论采用口腔灌洗法对经口气管插管患者进行口腔护理,能彻底清除口腔内的污垢,有效地控制细菌感染,降低患者口腔并发症的发生率,值得临床推广应用。     

Prevalence of oral cancer,oral potentially malignant disorders and other oral mucosal lesions in Cambodia

Objectives: To obtain data on the prevalence of oral mucosal lesions (OMLs) among Cambodians, and to assess the relationship between known risk habits of oral diseases with prevalence of oral potentially malignant disorders (OPMDs).

Design: This was a population-based, cross-sectional study whereby subjects were adults aged 18 years old and above. A workshop on the identification of OML was held to train and calibrate dental officers prior to data collection in the field. Sociodemographic and risk habits data were collected via face-to-face interview, whilst presence of OML and clinical details of lesions such as type and site were collected following clinical oral examination by the examiners. Data analysis was carried out using the Statistical Package for Social Science (SPSS) version 12.0. The association between risk habits and risk of OPMD was explored using logistic regression analysis.

Results: A total of 1634 subjects were recruited. Prevalence of OML for this population was 54.1%. Linea alba was the most common lesion seen (28.7%). This study showed an overall OPMD prevalence of 5.6%. The most common type of OPMD was leukoplakia (64.8%), followed by lichen planus (30.8%). Subjects who only smoked were found to have an increased risk for OPMD of almost four-fold (RR 3.74, 95%CI 1.89–7.41). The highest risk was found for betel quid chewers, where the increased risk observed was more than six times (RR 6.75, 95%CI 3.32–13.72). Alcohol consumption on its own did not seem to confer an increased risk for OPMD, however when practiced concurrently with smoking, a significant risk of more than five times was noted (RR 5.69 95%CI 3.14–10.29).

Conclusion: The prevalence of OML was 54.1%, with linea alba being the most commonly occurring lesion. Smoking, alcohol consumption and betel quid chewing were found to be associated with the prevalence of OPMD, which was 5.6%.     

阿片转换在吗啡不耐受的癌痛患者的临床研究

目的 旨在前瞻性地评估晚期癌痛患者对吗啡敏感的个体差异及转换应用另一种阿片类药物止痛治疗的需要、临床获益与不良反应.方法 对238例使用口服吗啡的中重度癌痛患者进行评估,是否存在吗啡不耐受.将评估为吗啡不耐受的60例患者随机分为两组:转换应用口服羟考酮(羟考酮组)或芬太尼透皮贴剂(芬太尼组)各30例.阿片转换10 d后采用疼痛强度数字评分量表评价临床疗效,并比较羟考酮和芬太尼两组的临床疗效与不良反应.结果 发现有74.8％ (178/238)的患者使用吗啡止痛有良好的疗效,25.2％ (60/238)患者对吗啡不耐受.行阿片转换治疗的患者中,76.7％ (46/60)的患者成功控制了疼痛,但羟考酮组与芬太尼组在疗效方面比较无差异(70.0％ vs 83.3％,P=0.222).60例患者阿片转换前后发生便秘(63.3％ vs 18.3％,P=0.000)及恶心呕吐(55.0％ vs 21.7％,P=0.000)等不良反应的差异有统计学意义,但两组比较无差异.结论 对于吗啡不耐受的癌痛患者转换应用口服羟考酮或芬太尼贴剂能显著提高疼痛控制率,改善患者生活质量.     

Interference of oral poliovirus vaccine on RIT 4237 oral rotavirus vaccine

A vaccination trial, performed on 86 3-month-old infants, has shown that the ability of the RIT 4237 live attenuated rotavirus strain to induce seroconversion is dramatically reduced when administered with live poliovirus vaccine. In a subsequent trial performed on 93 infants the attempt to overcome the poliovirus interference by administering two doses of associated vaccines was unsuccessful. No interference by the RIT 4237 strain on live attenuated polioviruses was observed.     

The global burden of oral diseases and risks to oral health

This paper outlines the burden of oral diseases worldwide and describes the influence of major sociobehavioural risk factors in oral health. Despite great improvements in the oral health of populations in several countries, global problems still persist. The burden of oral disease is particularly high for the disadvantaged and poor population groups in both developing and developed countries. Oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions and oropharyngeal cancers, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related oral disease and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life. The diversity in oral disease patterns and development trends across countries and regions reflects distinct risk profiles and the establishment of preventive oral health care programmes. The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys. In addition to poor living conditions, the major risk factors relate to unhealthy lifestyles (i.e. poor diet, nutrition and oral hygiene and use of tobacco and alcohol), and limited availability and accessibility of oral health services. Several oral diseases are linked to noncommunicable chronic diseases primarily because of common risk factors. Moreover, general diseases often have oral manifestations (e.g. diabetes or HIV/AIDS). Worldwide strengthening of public health programmes through the implementation of effective measures for the prevention of oral disease and promotion of oral health is urgently needed. The challenges of improving oral health are particularly great in developing countries.     

口腔念珠菌感染对口腔白斑癌变的作用

目的 探讨正常人、口腔白斑、口腔鳞状细胞癌的唾液培养真菌检出率,以阐明口腔念珠菌对口腔白斑癌变的作用.方法 采用唾液培养法,检测100名健康对照者、110例口腔白斑及11例鳞癌患者口腔念珠菌的感染情况.并记录受试者吸烟情况.进行卡方检验、双变量相关分析和二项分类logistic回归分析.结果 显示口腔白斑的恶性度与其唾液真菌培养阳性率相关(r=0.148,P=0.032).唾液真菌培养结果与受试者的病理分型相关(x2=21.757,P=0.010).唾液真菌培养结果与受试者的年龄和烟龄相关(OR年龄=0.72,P年龄=0.000;OR烟龄=0.37,P烟龄=0.01).结论 念珠菌感染很可能是促进上皮异常增生及白斑癌变的重要因素之一,临床上发现白斑患者应常规做唾液培养,并加强对白斑伴念珠菌感染患者的随访.     

Choice of oral contraceptives

A review of oral contraceptives, their potency, side effects, and factors in the choice of preparation, is presented. The type of oral contraceptive regimen influences the patient's reactions toward the pill. The regimens, unequal in biological properties, efficacy and side effects include: combined pills, sequential pills, and continuous low-dose progestagens or luteal supplementation. If the assumed role of endocrine balance in the genesis of some side-effects is correct, relief should clearly be obtained by changing preparations. Side-effects from estrogen excess decrease with a switch to a less estrogenic preparation and so forth. Regarding initial choice of preparation, an approximation to an individual's steroid balance can be made by carefully examining her genital tract, and by inquiring about symptoms of increased sensitivity to endogenous steroids. Estrogen sensitivity are suggested by symptoms that include nausea, emesis gravidarum premenstrual and/or intermenstrual congestion and abundant discharge of mucous at time of ovulation. Sensitivity to progestagen are seen in excessive anabolic weight gain during previous pregnancies.