改良口腔护理对ICU经口气管插管患者口腔感染的影响

Effect of Modified Oral Care on Oral Infection in ICU Patients with Orotracheal Intubation

摘要: 目的：探讨改良口腔护理对重症监护室经口气管插管患者口腔感染的影响，为优化气管插管患者口腔护理方案提供参考。方法：选取某三级甲等医院重症监护室收治的100例经口气管插管患者作为研究对象，按照随机数字表法分为对照组和观察组，每组50例。对照组实施常规口腔护理，观察组实施以口腔评估、负压吸引式擦洗、分区清洁、口腔保湿和动态护理频次为主要内容的改良口腔护理。比较两组口腔感染发生率、口腔清洁度、牙菌斑指数、口腔异味程度、口腔分泌物微生物培养阳性率及护理满意度。结果：观察组口腔感染发生率为4.00%，低于对照组的18.00%，差异具有统计学意义(P < 0.05)。护理后观察组口腔清洁度评分、牙菌斑指数和口腔异味评分均低于对照组，口腔舒适度评分高于对照组，差异具有统计学意义(P < 0.05)。观察组口腔分泌物微生物培养阳性率为12.00%，低于对照组的30.00%；护理满意度为96.00%，高于对照组的82.00%，差异均具有统计学意义(P < 0.05)。结论：改良口腔护理能够提高经口气管插管患者口腔清洁效果，减少牙菌斑和致病微生物定植，降低口腔感染发生风险，并可改善患者口腔舒适程度，具有一定的临床应用价值。

Abstract: Objective: To investigate the effect of modified oral care on oral infection in patients with orotracheal intubation in the intensive care unit (ICU), thereby providing a reference for optimizing oral care protocols for intubated patients. Methods: A total of 100 patients with orotracheal intubation admitted to the ICU of a tertiary hospital were selected and randomly assigned to a control group or an observation group, with 50 patients in each group. The control group received routine oral care, while the observation group received modified oral care involving oral assessment, negative-pressure suction cleaning, zone-based cleaning, oral moisturization, and dynamically adjusted care frequency. The incidence of oral infection, oral cleanliness score, plaque index, degree of oral malodor, positive rate of microbial cultures from oral secretions, and nursing satisfaction were compared between the two groups. Results: The incidence of oral infection in the observation group was 4.00%, which was significantly lower than the 18.00% recorded in the control group (P < 0.05). After the intervention, the oral cleanliness score, plaque index, and oral malodor score were significantly lower in the observation group than in the control group, while the oral comfort score was significantly higher (P < 0.05). The positive rate of microbial cultures from oral secretions was 12.00% in the observation group, lower than the 30.00% observed in the control group. Nursing satisfaction was 96.00% in the observation group, higher than the 82.00% in the control group. The differences were statistically significant (P < 0.05). Conclusion: Modified oral care can improve oral cleanliness in patients with orotracheal intubation, reduce dental plaque and pathogenic microbial colonization, decrease the risk of oral infection, and enhance oral comfort, demonstrating considerable value in clinical practice.