婴儿手口专用湿巾在患者口腔护理中的应用

目的 探索一种安全、舒适、高效的口腔护理新方法,能让意识清楚的患者更乐于接受并且不增加护士操作的强度和时间.方法 选取2014年10月~2015年12月于本院神经内科住院的留置鼻胃管、意识清楚但生活不能自理的患者207例为研究对象,随机分为对照组106例和实验组101例进行口腔护理.对照组采用0.9%生理盐水棉球口腔擦拭,实验组为婴儿手口专用湿巾口腔擦拭.两组患者口腔护理7d后进行口腔清洁度(护士的评估)评估和舒适度(患者的自我评价)评价,并对口腔并发症、护士的护理用时等进行对比.结果 实验组的口腔清洁度、患者舒适度明显高于对照组(P<0.05);实验组的口腔并发症、护士护理用时低于对照组(P<0.05).结论 采用婴儿手口专用湿巾替代生理盐水用于患者口腔护理能清洁口腔各部位,改善口腔气味,降低口腔并发症,减轻护士的工作量,同时患者乐于接受,对提高临床护理质量有一定的意义,值得临床推广应用.     

利咽解毒液在颌面部骨折术后口腔护理中的应用

目的探讨利咽解毒液在颌面部骨折术后口腔护理中的应用效果。方法行手术治疗的颌面部骨折患者150例,按照随机数字表法分成A、B、C 3组,各50例。术后分别给予A组生理盐水、B组甲硝唑、C组利咽解毒液进行口腔护理。对比3组患者的口腔黏膜表面菌量、口腔恢复情况以及口腔并发症发生情况。结果干预后即刻和4 h后,C组患者的口腔黏膜表面菌量少于A、B组患者,差异有统计学意义(P<0.05)。护理干预后,C组患者的伤口愈合时间、口腔舒适度以及疼痛评分均低于A、B组患者,差异有统计学意义(P<0.01)。C组患者的口臭程度、唾液功能障碍或口干程度优于A、B组患者,差异有统计学意义(P<0.05)。结论运用利咽解毒液对颌面部骨折术后患者进行口腔冲洗,能有效控制口腔黏膜表面菌量,促进创口恢复,减少疼痛以及术后并发症的发生。     

改良式口腔护理方法对经口气管插管患者口腔护理的效果研究

目的寻找普遍适用于经口气管插管患者的口腔护理方法,预防或减少感染的发生。方法将60例经口气管插管患者随机分为试验组30例和对照组30例,试验组采用改良式口腔护理方法,使用Oral-B牙刷、口镜、吸唾管、棉棒进行口腔护理;对照组采用传统的口腔护理方法。观察两组患者口腔护理后牙菌斑、口腔细菌株数有无差异。结果两组患者口腔护理后牙菌斑指数、口咽菌减少和转阴株数比较差异均有统计学意义（P〈0．05）。结论改良式口腔护理方法能有效去除牙菌斑,减少细菌数量,预防感染的发生。     

刷牙冲洗口腔护理对呼吸机相关性肺炎的影响

目的:探讨刷牙冲洗口腔护理法对呼吸机相关性肺炎(VAP)的影响。方法:将100例气管插管机械通气患者随机分为两组实验组与对照组各50例。两组均在机械通气开始24 h内进行口腔护理,2次/d,其中对照组进行常规口腔护理,实验组采用刷牙冲洗法进行口腔护理。比较两组患者口腔护理后细菌培养结果及口臭、口腔溃疡、疱疹、发生率。结果:两组患者口腔护理后细菌培养结果比较差异有统计学意义(P<0.05),口臭、口腔溃疡、疱疹、发生率比较差异也有统计学意义(P<0.01)。结论:采用刷牙冲洗法进行口腔护理能够减少患者口腔定植菌,降低口腔感染发生率,从而达到降低VAP发生率的目的。     

不同口腔护理液在口腔癌术后患者护理中的效果比较

目的:比较0.5%聚维酮碘液与生理盐水溶液在口腔癌患者术后护理中的效果。方法:选取我院口腔科2010年6月~2013年10月住院治疗患者87例为研究对象,随机分为对照组42例和观察组45例。对照组采用生理盐水溶液口腔护理,观察组采用0.5%聚维酮碘液口腔护理。比较两组患者口腔护理效果及口臭、口腔真菌感染发生。结果:观察组患者护理后舒适度明显高于对照组;观察组口臭、口腔真菌感染发生率均明显低于对照组(P0.05)。结论:口腔癌术后患者口腔护理液宜首选0.5%聚维酮碘溶液,可抑制口腔细菌生长,提高口腔护理效果。     

不同口腔护理方法在经口气管插管患者中的对比研究

目的探讨经口气管插管患者口腔护理的有效方法,观察应用美容小喷瓶喷雾法的临床效果。方法选取我院急诊科2009年6月～2011年6月经口气管插管患者142例,随机分为两组,对照组采用传统口腔护理方法;实验组采用口腔冲洗及擦拭后使用美容小喷瓶将口泰(复方洗必泰含漱液)雾化喷洒在口腔内,定期观察并记录发生口臭、口腔炎症和呼吸机相关性肺炎(VAP)的病例数。结果对照组口臭36例,口腔感染18例,VAP 22例;实验组口臭12例,口腔感染9例,VAP 18例,两组差异有显著意义(P<0.05)。结论实验组采用的口腔护理法能有效地提高经口气管插管患者的口腔护理质量,在预防患者口臭、口腔感染和VAP中效果显著,避免了传统口腔护理法易使患者发生误吸及意外拔管的危险,增加了病人的舒适度,降低了治疗成本。     

不同消毒剂对ICU 高频接触物体表面消毒效果的比较

目的通过对比三种消毒剂对ICU高频接触物体表面消毒后不同时间段的抑菌效果,从而为临床选择合适的物体表面消毒剂、规范ICU高频接触物体表面擦拭频率提供依据。方法分别采用一次性无纺布+改进型酸性氧化电位水、双链季铵盐消毒湿巾以及一次性无纺布+500mg/L含氯消毒液三种方法对ICU高频接触的物体表面进行擦拭,在擦拭前、擦拭后5min、擦拭后4h及擦拭后8h进行细菌采样,比较不同消毒剂在消毒后不同时刻的抑菌率、相关物体表面细菌合格率以及消毒成本。结果三种消毒剂消毒后即刻合格率均为100%,改进型酸性氧化电位水消毒后4h合格率和消毒后8h合格率高于其他两种消毒剂(均P<0.05);含氯消毒液灭菌率对涂有多重耐药菌MRSA的物体表面消毒后灭菌率最低,为99.28%,其余两组均为100%;改进型酸性氧化电位水单次使用成本最低,为0.81元。结论改进型酸性氧化电位水作为一种物体表面新型消毒剂,有效氯浓度低、消毒效果可靠,腐蚀性小,且消毒成本较低,可在医院感染重点科室推广使用。     

2.5%碳酸氢钠溶液行口腔冲洗预防ICU呼吸机相关性肺炎的临床研究

目的 探讨经口气管插管危重患者口腔护理方法,以减少口腔感染,减少口腔定植菌,切断胃-口腔-肺感染途径,减少呼吸机相关性肺炎.方法 采用前瞻性队列研究,按随机数字将受试对象分实验组和对照组.实验组每天采用2.5%碳酸氢钠溶液行口腔擦洗加冲洗,每天3次,对照组用生理盐水棉球行口腔擦洗,两组均在口腔护理前后测定pH值,48 h后行痰培养及口腔定植菌监测,分析两组患者呼吸机相关性肺炎(VAP)发生率、病原学检测结果.结果 实验组呼吸机相关性肺炎发生率降低(P<0.05),真菌感染率明显降低,口腔定植菌减少.结论 采用2.5%碳酸氢钠溶液行口腔冲洗可有效减少口腔定植菌,降低呼吸机相关性肺炎发生率.     

Impact of oral care on thirst perception and dry mouth assessments in intensive care patients: An observational study

ObjectivesTo investigate the impact of oral care on thirst perception and dry mouth assessments.Research designSingle-centre observational study.SettingIntensive care unit in a university hospital.Main OutcomeWe assessed thirst perception and dry mouth in adult patients before and after oral care. Thirst perception was assessed using a numerical rating scale and dry mouth was assessed using an oral moisture checking device and the modified Revised Oral Assessment Guide including tongue, mucous membranes and saliva.ResultsEighty-six patients were included. After oral care, thirst scores decreased by 1 (0 to 3, p < 0.01) and remained low only for one hour. Oral moisture was maintained at a normal level ≥ 27.0%, and mROAG was at a low level ≤ 4 before and after the oral care. The numerical rating score did not correlate with oral moisture (ρ = −0.01, p = 0.96) or the modified revised oral assessment guide (ρ = 0.09, p = 0.42). Among patients with thirst, 60 (70%) patients complained of thirst at the assessment timepoints, but only 17 (20%) patients complained independently.ConclusionThirst perception was dissociated from dry mouth before and after oral care. Thirst must be frequently assessed and treated.     

碘伏口腔护理预防口腔手术后感染的效果研究

目的探讨用0.5%碘伏代替生理盐水做口腔护理的效果。方法将60例择期口腔手术病人随机分为2组,每组各30例,分别用0.5%碘伏和生理盐水做口腔护理,每天早晨和晚上各1次,观察并记录手术后口腔感染情况,并做统计学处理。结果观察组在粘膜完整性、牙龈是否肿胀出血、口腔气味和感染方面的预防效果明显优于对照组(p<0.01)。结论0.5%碘伏口腔护理对预防口腔手术后感染有显著效果,值得推广应用。     

刷牙冲洗法口腔护理在ICU患者经口气管插管中的效果研究

目的 探究刷牙冲洗法口腔护理在重症监护(ICU)患者经口气管插管中的效果。方法 选择2017年1月至2018年12月我院ICU监护治疗经口气管插管行机械通气的128例患者作为研究对象。采用随机数字表法将所选患者分为试验组和对照组,各64例。对照组给予传统口腔护理,试验组采用刷牙冲洗法对患者口腔进行护理。统计和比较患者呼吸机相关性肺炎(VAP)发生及口腔异味程率,此外统计患者口腔并发症的发生情况。结果 经刷牙冲洗法口腔护理后试验组VAP发生率明显低于对照组[12.5% vs 29.7%,P<0.05];经刷牙冲洗法口腔护理后试验组口腔异味率明显低于对照组[20.3% vs 57.8%,P<0.05];主要口腔并发症由口腔炎症、口腔溃疡及真菌感染,经刷牙冲洗法口腔护理后试验组并发症的发生率明显低于对照组[4.7% vs 17.2%,P<0.05]。结论 ICU患者经口气管插管后采用刷牙冲洗法口腔护理可有效清除细菌移位,降低VAP的发生及口腔异味,值得在临床推广使用。     

牙刷刷牙结合温开水冲洗在经口气管插管口腔护理中的应用效果观察

目的：探讨牙刷刷牙结合温开水冲洗在经口气管插管口腔护理中的应用效果。方法选取2012年5月-2013年6月在IC U监护治疗经口气管插管患者84例,随机将其分为实验组和对照组各42例。对照组采用生理盐水棉球进行口腔护理,实验组使用牙刷刷牙结合温开水冲洗方法进行口腔护理。比较2组患者的口腔护理应用效果。结果实验组口咽细菌、牙菌斑、口腔气味、住院时间、医疗费用、患者满意度情况均明显优于对照组。结论经口气管插管患者采用牙刷刷牙结合温开水冲洗进行口腔护理,可以有效清洁患者口腔、减少肺部细菌感染的发生。     

A randomized,double-blind clinical study to assess the antimicrobial effects of a cetylpyridinium chloride mouth rinse on dental plaque bacteria

Background: Studies with cetylpyridinium chloride (CPC) mouth rinses that range from 1 use to 6 months of use have documented the clinical efficacy of these formulations on supragingival plaque and gingivitis.Objective: The objective of the present study was to compare the effects of a commercially available mouth rinse containing 0.05% CPC versus a fluoride mouth rinse on the anaerobic bacteria found in dental plaque. Antimicrobial effects on the organisms of the supragingival plaque, a natural biofilm, were determined after 1 use and after 14 days of use of each mouth rinse.Methods: After enrollment, adult subjects from China completed a 1-week washout period and provided baseline samples of supragingival plaque for analysis of anaerobic bacteria. Subjects were randomly assigned to receive a commercially available mouth rinse formulated with 0.05% CPC or a fluoride mouth rinse. Subjects were assigned to each group according to a computer-generated randomization sequence. They were instructed to rinse with 20 mL of either the CPC or the fluoride mouth rinse for 30 seconds. Microbiologic analyses of dental plaque samples were conducted 12 hours after the first use of assigned mouth rinse. Subjects were instructed to continue twice-daily rinsing with their assigned mouth rinse for the next 14 days in addition to brushing their teeth with a commercial fluoride toothpaste. Dental plaque samples for microbiologic analyses were collected on day 15; this was done 12 hours after the final use of the assigned mouth rinses. A dentist conducted oral examinations before each sample collection to evaluate hard and soft tissue health over the course of the study.Results: The study included 117 adults (62 females, mean age, 28.70 years; 55 males, mean age, 30.41 years). Subjects rinsing with the CPC mouthwash (n = 58; mean age, 29.41 years) reported significant reductions in anaerobic bacteria versus those issued the fluoride rinse (n = 59; mean age, 29.61 years) 12 hours after 1 use and 12 hours after 14 days of use (P < 0.001). The mean percent reduction in anaerobic bacteria between the CPC mouth rinse and the fluoride mouth rinse was 29.98% after 1 use and 57.90% after 14 days of use. All enrolled subjects completed the study without any adverse events.Conclusion: Use of the CPC mouth rinse was associated with significant reductions in the anaerobic bacteria of supragingival plaque compared with fluoride mouth rinse use in these adult subjects.     

40例颧眶骨折患者的围手术期护理

总结40例颧眶骨折患者围手术期的护理要点,术前加强生命体征、颅脑损伤症状的观察及安全护理,术后重视口腔、眼及伤口护理,对于存在复视及张口受限的患者,进行眼肌功能训练和张口训练是围手术期护理的关键.40倒患者术后3个月均恢复良好.     

Oral myiasis after cerebral infarction in an elderly male patient from southern China: A case report

BACKGROUNDMyiasis is a rare but risky pathology caused by a parasitic infestation of humans and animals by the dipterous larva. Oral myiasis occurs when soft tissues of the oral cavity are invaded by the larvae of flies. It is not a common disease for the reason that the oral cavity is not easily reachable for the fly to lay eggs. But it can cause pain, infection, uncomfortable feeling when the worms move, tissue destruction and/or even life-threatening hemorrhages.CASE SUMMARYWe reported a case of oral myiasis after cerebral infarction in a 78-year-old male patient from southern China (Guangdong Zhanjiang). As a result of cerebral infarction, he suffered from right hemiplegia, mobility and mental decline for about 3 mo. He had difficulty swallowing and was fed via a feeding tube. He mostly engaged in mouth breathing and had poor oral and dental hygiene. More than 20 live larvae were collected from the patient’s oral cavity, which were localized in the maxillary gingiva, the mandibular gingiva and the tongue. The patient recovered after the routine oral cleaning, removal of maggots, debridement and anti-infection treatment.CONCLUSIONEarly diagnosis and treatment of this infestation are essential due to the bothersome symptoms, such as inflammation, intense anxiety over the larvae movement, possible serious complications, etc. Clinical staff should be familiar with this infestation, and this disease should be considered, especially in physically and mentally disabled patients or those at significant risk for infection. Necessary measures, including good sanitation, personal and environmental hygiene and special care should be adopted so as to prevent this disease.     

造血干细胞移植患者口腔粘膜炎的观察及护理

目的观察41例患者口腔粘膜炎发生、发展的规律,为临床护理提供科学的依据。方法预先设计好口腔粘膜炎的观察表,每次口腔护理前对口腔粘膜认真评估,逐项填写。结果本组口腔粘膜炎的发生率为83.7%%;发生部位颊(46.3%),舌(34.1%)、唇(31.7%)、齿龈和腭(均为29.3%);发生程度0级、Ⅰ级占83.7%;发生与粒细胞下降速度、幅度、持续时间均有关;粘膜炎时微生物检测均为常居菌。结论口腔粘膜炎是造血干细胞移植患者常见而严重的并发症。虽发生率高,但只要仔细观察、有效护理,是可以降低口腔粘膜炎发生程度的。     

三种口腔护理方法对预防呼吸机相关性肺炎发生影响的meta分析

目的 评价三种口腔护理方法 对预防呼吸机相关性肺炎发生的效果.方法电子检索1980年1月至2016年3月CNKI和Pubmed等数据库国内外机械通气患者口腔护理方面的研究.采用RevMan5.3软件进行数据合并分析.结果 共纳入15个研究,1929名研究对象.meta分析显示,口腔冲洗法优于口腔擦洗法(随机效应模型,95%CI:0.34(0.22,0.52),P<0.001),口腔擦洗+口腔冲洗法优于单独使用口腔擦洗法(随机效应模型,95%CI:0.68(0.48,0.95),P<0.05),单独的口腔冲洗法与口腔擦洗+口腔冲洗法并无明显差异(固定效应模型,95%CI:0.62(0.36,1.06),P>0.05).结论 口腔冲洗法或口腔擦洗联合口腔冲洗较口腔擦洗能更好地预防呼吸机相关性肺炎的发生.     

刷牙冲洗法用于经口气管插管患者口腔护理的效果

目的 观察刷牙冲洗法用于口腔护理的效果,为经口气管插管的患者提供更好的护理措施.方法 将100例经口气管插管的患者分为两组,对照组采用传统口腔护理方法,实验组采用儿童软毛牙刷蘸牙膏刷牙,然后用生理盐水冲洗的方法进行口腔护理.结果 患者口臭、真菌感染率及呼吸机相关性肺炎的发生率均下降,细菌培养菌株数减少(P＜0.01...     

The value of chlorhexidine gluconate wipes and prepacked washcloths to prevent the spread of pathogens—A systematic review

BackgroundUse of chlorhexidine gluconate wipes and pre-packed washcloths has been described for preventing pathogen spread in healthcare settings.AimTo assess the impact of chlorhexidine washcloths/wipes in preventing the spread of pathogens.MethodsExtensive and structured literature search from studies in Google Academic, Cochrane Library, Web of Science, Pubmed and Cinahl from their inception until November 2012.FindingsFinal analysis included 15 studies, 9 of which were randomised controlled trials. The most frequent setting was the intensive care unit. In intensive care units, a significant reduction of bloodstream infection was associated with intervention and 3 studies revealed a decrease in blood culture contamination. One study showed a decrease in staff and environmental contamination and no increase in chlorhexidine resistance with intervention. Positive blood cultures for multiple pathogens also declined with intervention. In a paediatric intensive care unit, intervention decreased bacteraemia and catheter-associated bloodstream infection. In hospital wards, intervention was associated to a 64% reduction of pathogen transmission. One study had no statistically significant results. Pre-surgical chlorhexidine use significantly decreased bacterial colonisation but had no impact on surgical site infections. Regarding maternal and perinatal setting, one study did not show reduction of early onset neonatal sepsis and pathogen transmission. Another study of vaginal and neonatal decolonisation with chlorhexidine wiping revealed significant reduction in colonisation. One study concluded that single and multiple umbilical cord cleansing reduced the likelihood for a positive swab in 25% and 29%, respectively. Neonatal wiping maintained low levels of skin colonisation for a 24 h period, for multiple pathogens.ConclusionCurrent evidence supports the usefulness of chlorhexidine washcloths and wipes in an intensive care, hospital and pre-surgical setting. More studies are required to encourage its use for prevention of perinatal and neonatal transmission of pathogens.     

护理人员对经口气管插管口腔护理认知状况的研究

经口气管插管是救治严重呼吸衰竭患者的重要措施,为临床医生针对呼吸衰竭的各种病因治疗争取时间并创造条件,但是插管又容易引发重症监护病房(intensive care unit,ICU)重要的医院感染问题———机械通气性肺炎(ventilated associated pneu-monia,VAP)的发生。VAP是指机械通气4