摘要
目的探讨重建重症患者口咽胃内环境的有效护理措施,以降低内源性感染的发生率。方法将60例重症患者随机分为对照组和观察组各30例。两组均监测患者口咽部及胃内的pH值、细菌生长变化及行痰培养。观察组根据各部位pH值及细菌培养监测结果给予相应口腔护理液进行口腔护理、酸化胃内容物、选择性肠道去污染等措施清除感染源;对照组予ICU常规护理。结果护理干预后第3、7天,观察组口咽部及胃内的pH值及细菌培养阳性率与对照组比较,差异有显著性意义(均P<0.05);患者入院7d时,观察组肺部感染率显著低于对照组(P<0.05)。结论加强对危重症患者口咽胃内的pH值及细菌变化监测,及时采取护理干预措施,防止菌群异位定植与移位,可显著降低内源性感染的发生。
Objective To reduce the rate of endogenous infection in severely ill patients by re-establishing internal environment of oropharynx and stomach. Methods Sixty severely ill patients were randomly divided into a control group （n=30） and an observation group （n=30）. Oropharyngeal and gastric pH values, bacterial growth and sputum culture were monitored in both groups. Subjects in the control group received routine care, while those in the observation group were given mouth hygiene, acidification of gastric contents and selective decontamination of digestive tracts based on the results of monitoring to eliminate infection sources. Results There were significant differences in pH values of oropharynx and stomach between the control group and the observation group on the 3rd and the 7th day, and so was the positive rate of bacteria culture （P%0.05 for all）. The rate of pulmonary infection in the observation group was significantly lower than that in the control group on the 7th day （P〈0.05）. Conclusion Intensified monitoring of oropharyngeal and gastric pH values, as well as the bacteria growth, and taking effective interventions to prevent ectopic colonization and transposition of bacteria, can reduce the rate of endogenous infection.
基金
华中科技大学同济医学院附属同济医院2006年中青年科研基金资助项目(2006033)
关键词
重症患者
口咽
胃
内环境
内源性感染
pH值
细菌培养
severely ill patients
oropharynx
stomach
internal environment
endogenous infection
pH values
culture of bacteria
