改良口腔护理在EICU使用呼吸机治疗患者集束化护理中的效果

目的 探讨改良口腔护理在EICU使用呼吸机治疗患者集束化护理中的效果。 方法 采用随机数字法将宁波华美医院2018年1—10月收治的138例EICU使用呼吸机治疗的患者分为2组，每组69例。对照组给予集束化护理，观察组给予改良口腔护理的集束化护理。比较2组患者护理3 d、7 d后口腔卫生(口臭、牙龈肿胀出血、口腔溃疡)改善情况，护理结束后痰病原菌菌株数、呼吸机相关性肺炎(VAP)发生情况，以及2组患者EICU住院时间、机械通气时间。 结果 护理3 d后，观察组口臭改善率为55.56%，明显优于对照组的30.19%(P<0.05)；护理7 d后，观察组口臭、牙龈肿胀出血及口腔溃疡改善率分别为94.44%、80.56%及54.17%，显著优于对照组的66.04%、39.47%及24.00%(均P<0.05)。护理后，观察组痰病原菌检出菌株数为29株，对照组痰病原菌检出菌株数为50株，2组比较差异有统计学意义(P<0.05)。观察组EICU住院时间、机械通气时间明显短于对照组(均P<0.05)。护理后，观察组VAP发生率为4.35%，显著低于对照组的17.39%(P<0.05)。 结论 改良口腔护理的集束化护理可明显缩短EICU使用呼吸机治疗患者EICU住院时间与机械通气时间，改善患者口腔卫生，降低VAP发生率。 

Effect of improved oral care in EICU using ventilator to treat patients with clustering Nursing

Objective To investigate the effect of improved oral care in EICU using ventilator to treat patients with clustering nursing. Methods Randomized digital method was used to divide 138 patients with EICU admitted to Ningbo Huamei Hospital into two groups, 69 cases in each group. The control group was given clustering care, and the observation group was given clustered care for improved oral care. The improvement of oral hygiene (bad breath, swollen gum bleeding, oral ulcer) after 3 days and 7 days of nursing care, the number of pathogenic bacteria and the occurrence of ventilator-associated pneumonia (VAP) after nursing, and EICU hospitalization time, mechanical ventilation time in the two groups were compared. Results After 3 days of nursing, the improvement rate of bad breath in the observation group was 55.56%, which was significantly better than that in the control group (30.19%， P<0.05). After 7 days of nursing, the improvement rates of bad breath, swollen gums and oral ulcer in the observation group were 94.44%, 80.56% and 54.17%, which were significantly better than that of the control group (66.04%, 39.47% and 24.00%， all P<0.05). After the nursing, 29 strains of the pathogens were detected in the observation group, and 50 strains were detected in the control group (P<0.05). The hospitalization time and mechanical ventilation time of the EICU in the observation group were significantly shorter than those in the control group (all P<0.05). After the nursing, the incidence of VAP in the observation group was 4.35%, which was significantly lower than that in the control group (17.39%， P<0.05). Conclusion The clustering care with improved oral care can significantly shorten the EICU hospitalization time and mechanical ventilation time in the EICU using ventilator treatment, which can significantly improve the patient's oral hygiene and reduce the incidence of VAP.