摘要
目的研究不同口腔干预措施对长期住院患者口腔呼吸道需氧致病细菌定植率及医院内获得性肺炎(hospital acquired pneumonia,HAP)发病率的影响。方法将62名老年患者(>65岁)采用数字表法随机分为试验组和对照组,每组31例。试验组与对照组分别每日2次予复方氯己定、0.9%氯化钠注射液清洁口腔,研究对象均在入组第1天(干预前)和第30天(干预后)取口腔标本(咽拭子、龈上菌斑),比较不同的口腔干预措施对口腔呼吸道需氧致病细菌定植率和HAP发病率的影响。结果①试验组口腔干预前后咽部呼吸道需氧致病细菌定植率分别为58.06%及32.26%,口腔干预前后龈上菌斑定植率分别为55.17%及27.59%,差异均具有统计学意义(P<0.05);②对照组口腔干预前后咽部呼吸道需氧致病细菌定植率分别为54.84%及32.26%;口腔干预前后,龈上菌斑定植率分别为53.57%及28.57%,差异亦均具有统计学意义(P<0.05);③试验组与对照组半年内HAP发病率分别为10.20/1 000住院日及14.12/1 000住院日,差异具有统计学意义(P<0.05)。结论每日应用复方氯己定和0.9%氯化钠注射液行口腔清洁均可以减少口腔呼吸道需氧致病细菌定植率,但长期应用复方氯己定较0.9%氯化钠注射液可以减少HAP的发生率。
Objective To investigate the effects of different oral interventions to the incidence of the oropharyngeal respiratory aerobic pathogenic bacterial colonization and the morbidity of hospital-acquired pneumonia （HAP） in the long-term hospitalized elderly people. Methods Totally 62 elderly patients （〉65 years） seen in our hospital were randomly divided into the treatment group （n = 31 ） swab, supragingival plaque of every subjects at the first day（before intervention） and 30th day（ after intervention） after enrolled. The incidence of the oropharyngeal respiratory aerobic pathogenic bacterial colonization and the morbidity of HAP between the two groups were compared. Results ① The incidence of the pharyngeal respiratory aerobic pathogenic bacterial colonization after oral intervention（32.26% ） was lower than before （58.06%） in the treatment group. And the incidence of the supragingival plaque colonization after oral intervention（27.59% ） was lower than that obtained before （55. 17% ）. The differences were all statistically significant （P〈0. 05 ）. ② The incidence of the pharyngeal respiratory aerobic pathogenic bacterial colonization after oral intervention （ 32.26% ） was lower than that （54.84%） in the control group. The incidence of the supragingival plaque colonization after oral intervention（28.57% ） was also lower than the previous one （53.57%）. The differences were all statistically significant （P〈0.05）. ③ The morbidity of HAP of the treatment group and the control group were 10.20/1 000 hospitalizations and 14. 12/1 000 hospitalizations, respectively. The difference was statistically significant （P〈 0.05）. Conclusion The oral intervention of using compound chlorhexidine gargle or sterile saline daily both decreased the incidence of the oropharyngeal respiratory aerobic pathogenic bacterial colonization. But rinsing the mouth using compound chlorhexidine gargle for a long term could decrease the morbidity of HAP as compared with sterile saline.
出处
《首都医科大学学报》
CAS
2013年第4期582-586,共5页
Journal of Capital Medical University
基金
北京市卫生局青年科学研究(QN2009-005)资助项目~~
