Berry Angela M, Davidson Patricia M
Intensive Care Services, Westmead Hospital, University of Western Sydney, Sydney, Australia. angela_
Intensive Crit Care Nurs. 2006 Dec;22(6):318-28. doi: 10.1016/j.iccn.2006.04.003. Epub 2006 Jun 27.
The role of oral hygiene in maintaining the health and well being of patients in the intensive care unit (ICU) is indisputable. This importance is not reflected in the body of research related to ICU practice. While a number of studies have examined oral hygiene practices in oncological patients there is significantly less attention devoted to these practices in the critically ill.
This paper has two discrete yet interrelated aims. Firstly, in relation to current available evidence and based on a sound knowledge of oral physiology, identify barriers to effective oral hygiene and subsequent effectiveness of the most commonly used and recommended methods of providing oral hygiene in the critically ill population. Secondly, informed by the critical review, identify recommendations for practice and future intervention studies.
To date, there is no definitive evidence to determine the most appropriate method of oral hygiene including the use of beneficial mouth rinses. Barriers identified in this review to providing optimal hygiene include: (1) mechanical barriers and equipment issues, (2) perceptions of the importance of mouth care and empathy with patient discomfort by nurses, (3) altered patient sensory perception and discomfort and (4) difficulties in patient communication. In spite of these challenges opportunities for collaborative research and increasing expertise in nurse researchers creates a climate to derive solutions to these factors.
It is clearly evident from this review of oral hygiene practices in intensive care that the need for ongoing research is of paramount importance. ICU nurses undeniably require rigorous research studies in order to inform their practice in the provision of oral hygiene for critically ill patients.
口腔卫生对重症监护病房（ICU）患者的健康和福祉的作用是无可争议的。然而，这一重要性在与ICU实践相关的研究中并未得到体现。虽然有多项研究探讨了肿瘤患者的口腔卫生实践，但对重症患者的这些实践关注明显较少。
本文有两个既独立又相互关联的目标。首先，根据现有的证据并基于对口腔生理学的充分了解，确定有效口腔卫生的障碍以及在重症患者中最常用和推荐的口腔卫生方法的后续效果。其次，在批判性综述的基础上，确定实践建议和未来的干预研究。
迄今为止，尚无确凿证据确定最适当的口腔卫生方法，包括使用有益的漱口水。本综述中确定的提供最佳卫生的障碍包括：（1）机械障碍和设备问题；（2）护士对口腔护理重要性的认知以及对患者不适的同理心；（3）患者感觉知觉改变和不适；（4）患者沟通困难。尽管存在这些挑战，但合作研究的机会以及护士研究人员专业知识的增加营造了一种氛围，有助于找到应对这些因素的解决方案。
从对重症监护口腔卫生实践的这一综述中可以明显看出，持续研究的必要性至关重要。毫无疑问，ICU护士需要严格的研究来指导他们为重症患者提供口腔卫生护理的实践。
