官微已推送--口腔卫生对预防呼吸机相关性肺炎的影响
口腔卫生对预防呼吸机相关性肺炎的影响翻译：潘红平、陈志锦审核：陈燕琼、陈志锦在接受机械通气患者中，医院获得性肺炎的发生与牙菌斑及口咽部定植有关。通过防止口腔致病菌定植，定植的阻断可能充当着预防呼吸机相关性肺炎的过程。 由de Lacerda等人员设计的一项前瞻性随机试验研究，在心胸外科重症监护病房患者中， 检验与0.12%氯已定溶液漱口相比，使用0.12%氯已定凝胶刷牙的口腔清洁方式，能否够降低呼吸机相关性肺炎的发生率、机械通气持续时间、住院时间乃至重症监护病房死亡率。因为这是一项随机试验，研究使用CONSORT 2010检查表标准，所以该研究的开展在获得了伯南布哥联邦大学健康科学中心研究伦理委员会批准证书（CAAE）04300012500005208的批准才得以进行。 在一共716名入住ICU的患者中，219名患者符合纳入标准，其中213名患者被纳入研究：108名患者被随机分配到对照组，105名患者为干预组。0.12%氯已定凝胶刷牙的干预组在整个随访期间表现出较低的呼吸机相关性肺炎发生率，尽管差异无统计学意义（P=0.084）。而且ICU住院时间和死亡率的差异同样无统计学意义（P=0.064），但干预组平均机械通气时间显着减少（P=0.018）。 此项研究结果表明，接受0.12%氯已定凝胶刷牙的患者，机械通气持续时间显著减少。并且，在呼吸机相关性肺炎发生率以及ICU住院时间方面呈下降趋势，虽然差异无统计学意义。 原 文Researchers Study Impact of Oral Hygiene in the Prevention of Ventilator-Associated PneumoniaNosocomial pneumonia has correlated to dental plaque and to oropharynx colonization in patients receiving mechanical ventilation. The interruption of this process, by preventing colonization of pathogenic bacteria, represents a potential procedure for the prevention of ventilator-associated pneumonia (VAP). The study design by de Lacerda, et al. (2017) was a prospective, randomized trial to verify if oral hygiene through toothbrushing plus chlorhexidine in gel at 0.12% reduces the incidence of ventilator-associated pneumonia, the duration of mechanical ventilation, the length of hospital stay and the mortality rate in ICUs, when compared to oral hygiene only with chlorhexidine, solution of 0.12%, without toothbrushing, in adult individuals under mechanical ventilation, hospitalized in Clinical/Surgical and Cardiology Intensive Care Units (ICU). The study protocol was approved by the Ethical Committee of Research of the Health Sciences Center of the Federal University of Pernambuco – Certificate of Ethical Committee Approval (CAAE) 04300012500005208. Because it was a randomized trial, the research used CONSORT 2010 checklist criteria. Seven hundred sixteen patients were admitted into the ICU; 219 fulfilled the criteria for inclusion and 213 patients were included; 108 were randomized to control group and 105 to intervention group. Toothbrushing plus 0.12% chlorhexidine gel demonstrated a lower incidence of VAP throughout the follow up period, although the difference was not statistically significant (p = 0.084). There was a significant reduction of the mean time of mechanical ventilation in the toothbrushing group (p = 0.018). Regarding the length of hospital stay in the ICU and mortality rates, the difference was not statistically significant (p = 0.064). The results obtained showed that, among patients undergoing toothbrushing there was a significant reduction in duration of mechanical ventilation, and a tendency to reduce the incidence of VAP and length of ICU stay, although without statistical significance.Reference: de Lacerda Vidal CF, et al. Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator-associated pneumonia: a randomized study. BMC Infectious DiseasesBMC series – open, inclusive and trusted201717:112在接受机械通气患者中，医院获得性肺炎的发生与牙菌斑及口咽部定植有关。通过防止口腔致病菌定植，定植的阻断可能充当着预防呼吸机相关性肺炎的过程。
学习了老师分享的内容！ 很好的资料，感谢分享，学习了。
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