刷牙与刷牙加洗必泰应用预防儿童术后肺炎的效果比较。

The impact of tooth brushing versus tooth brushing and chlorhexidine application to avoid postoperative pneumonia in children.

机构信息

Department of Stomatology, Pediatric Odontology Service, Hospital Infantil de México Federico Gómez, México City, Mexico.

出版信息

Am J Infect Control. 2019 Nov;47(11):1340-1345. doi: 10.1016/j.ajic.2019.05.018. Epub 2019 Jul 16.

DOI:10.1016/j.ajic.2019.05.018

PMID:31324495

Abstract

BACKGROUND

The pathogenesis of postsurgical pneumonia is a complicated and multifactorial process, in which elements like oral bacteria, orotracheal intubation, and dental hygiene play an important role. The objective of this study was to evaluate the efficacy of 2 types of oral hygiene interventions in decreasing cases of postsurgical pneumonia.

METHODS

In pediatric patients scheduled for surgery, a quasi-experimental study was carried out over a 2-year period to evaluate the efficacy of 2 types of oral hygiene interventions. There were 2 groups of intervention with 1 group for comparison. Intervention groups were tooth brushing by a dentist (intervention group 1) and dental brushing by parents + chlorhexidine gluconate (intervention group 2). Data from the year with no oral hygiene interventions were used as the baseline group.

RESULTS

A total of 2,535 surgical procedures were followed. Baseline group incidence of postoperative pneumonia was 10 per 1,000 surgeries, 0.2 per 1,000 surgeries in the intervention group 1 (P = .04), and 0.8 per 1,000 surgeries in the intervention group 2. Intervention group 1 was protective against postoperative pneumonia (odds ratio, 0.06; P = .02; 95% confidence interval, 0.033-0.079), but there was no benefit with intervention group 2 (odds ratio, 0.87; P = .599; 95% confidence interval, 0.52-1.46).

CONCLUSIONS

Dental brushing performed before surgery by a pediatric dentist was effective in reducing the incidence of postoperative pneumonia in pediatric patients.

摘要

背景

术后肺炎的发病机制是一个复杂的多因素过程，口腔细菌、经口气管插管和口腔卫生等因素起着重要作用。本研究旨在评估 2 种口腔卫生干预措施降低术后肺炎发生率的效果。

方法

在计划手术的儿科患者中，进行了为期 2 年的准实验研究，以评估 2 种口腔卫生干预措施的效果。干预组有 2 组，其中一组为对照组。干预组分别为牙医刷牙（干预组 1）和家长+洗必泰刷牙（干预组 2）。未进行口腔卫生干预的那一年的数据被用作基线组。

结果

共随访了 2535 例手术。基线组术后肺炎发生率为每 1000 例手术 10 例，干预组 1 为每 1000 例手术 0.2 例（P=0.04），干预组 2 为每 1000 例手术 0.8 例。干预组 1 对术后肺炎有保护作用（比值比，0.06；P=0.02；95%置信区间，0.033-0.079），但干预组 2 没有获益（比值比，0.87；P=0.599；95%置信区间，0.52-1.46）。