首次口腔护理时间对气管插管患者早发性呼吸机相关肺炎发生率的影响

目的探讨首次口腔护理时间对气管插管患者早发性呼吸机相关肺炎(VAP)发生率的影响。方法将入住我院ICU的120例经口气管插管患者随机均分为三组,分别在气管插管后4h内(含4h)、4~8h(含8h)、8~12h(含12h)介入首次口腔护理。比较三组患者早发性呼吸机相关肺炎发生率、机械通气时间、入住ICU时间和病死率等指标。结果三组患者的机械通气时间、入住ICU时间差异有统计学意义,早发性呼吸机相关肺炎发生率、病死率差异无统计学意义。但是,随着首次口腔护理时间的向后推迟,患者的早发性呼肺炎机相关发生率和病死率逐渐升高。结论在插管后4h内介入首次口腔护理,可降低患者的早发性呼吸机相关肺炎发生率与病死率,缩短机械通气时间、入住ICU时间,改善患者预后。

The effect of the first time oral care on the incidence of early-onset ventilator-associated pneumonia for patients with endotracheal intubation

Objective To explore the effect of oral care time on the incidence of early-onset ventilator-associated pneumonia of patients with endotracheal intubation.Methods A total of 120 cases of patients with endotracheal intu-bation in the intensive care unit(ICU )of our hospital were enrolled,and then randomly divided into three groups. The implementation of oral care for the first time in three groups was within 4 h(4 h included)after intubation,4 h~8 h(8 h included)after intubation,8 h~12 h (12 h included)after intubation respectively.Some prognostic indicators in three groups were compared,such as baseline data on admission,incidence of early-onset ventilator-associated pneumonia,duration of mechanical ventilation,length of stay in the intensive care unit and mortality.Results There was significant difference in duration of mechanical ventilation and the length of stay in ICU for the three groups (P<0.05).There was no significant difference in the baseline data,incidence of early-onset ventilator-associated pneu-monia and mortality (P>0.05).However,as implementation of oral care for the first time delayed,the incidence of early-onset ventilator-associated pneumonia and mortality are gradually increased.Conclusions The incidence of early-onset ventilator-associated pneumonia and mortality can be reduced by oral care for the first time implemented within 4 h after intubation,and the duration of mechanical ventilation and length of stay in ICU can be shortened.Te progno-sis of patients can be obviously improved at the same time.