Lev Amiram, Aied Abu Sebeih, Arshed Shibli
General Intensive Care Unit, Emek Medical Center, Israel.
J Infect Prev. 2015 Mar;16(2):76-81. doi: 10.1177/1757177414560252. Epub 2014 Dec 10.
We compared the incidence of ventilator associated pneumonia (VAP) among patients treated with comprehensive oral care to those treated with conventional methods of oral care.
We conducted a prospective, controlled study in an intensive care unit of 90 ventilated patients. Patients in the study group received a comprehensive oral hygiene treatment regimen that involved tooth brushing, suctioning, sodium bicarbonate, rinsing with an antiseptic solution containing 1.5% hydrogen peroxide and a mouth moisturiser. Patients in the control group received a more conventional treatment that included cleaning with a sponge and atraumatic clamp, and rinsing with a 0.2% solution of chlorhexidine gluconate.
Among the 90 patients admitted to the ICU, 8.9% of the study group developed VAP compared with 33.3% of the control group (< 0.004). The development of VAP per 1,000 ventilation days was 10.2 in the study group, and 29.5 in the control group (< 0.06). The mean number of ventilation days and the mean number of hospitalisation days were also lower in the study group.
In patients who are ventilated, a comprehensive oral hygiene treatment regimen that includes tooth brushing, suctioning and rinsing with an antiseptic is more effective in preventing VAP than more conventional protocols.
我们比较了接受全面口腔护理的患者与接受传统口腔护理方法的患者中呼吸机相关性肺炎（VAP）的发生率。
我们在一个重症监护病房对90例使用呼吸机的患者进行了一项前瞻性对照研究。研究组患者接受了全面的口腔卫生治疗方案，包括刷牙、吸痰、使用碳酸氢钠、用含1.5%过氧化氢的抗菌溶液冲洗以及使用口腔保湿剂。对照组患者接受了更传统的治疗，包括用海绵和无创伤夹清洁，并用0.2%葡萄糖酸氯己定溶液冲洗。
在入住ICU的90例患者中，研究组8.9%发生了VAP，而对照组为33.3%（<0.004）。每1000个通气日VAP的发生率在研究组为10.2，在对照组为29.5（<0.06）。研究组的平均通气天数和平均住院天数也更低。
对于使用呼吸机的患者，包括刷牙、吸痰和用抗菌剂冲洗的全面口腔卫生治疗方案在预防VAP方面比更传统的方案更有效。
