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目的研究老年心脏直视手术患者气管插管前采用0.5%的聚维酮碘口腔清洁对患者呼吸机相关肺炎发生率(VAP)的效果。方法纳入2014年1~12月在本院实施心脏手术的老年患者59例,随机将患者分为观察组和对照组,对照组进入手术室后常规气管插管;观察组进入手术室后气管插管前采用0.5%的聚维酮碘,用电动牙刷刷牙3 min、含漱2 min、仰漱1 min,术后两组患者均给予常规口腔护理,比较两组患者的VAP发生率。结果观察组和对照组两组患者VAP发生率、ICU住院时间及机械通气时间比较差异均有统计意义(P<0.05)。结论气管插管前用0.5%的聚维酮碘能够有效减少患者口腔的定植菌及牙菌斑指数,降低老年心脏直视手术患者的VAP发生率,并减少通气时间、机械通气时间、住院时间及花费。
Objective To investigate the effect of 0.5% povidone-iodine oral cleaning on the incidence of ventilator-associated pneumonia (VAP) in elderly patients undergoing open heart surgery. Methods A total of 59 elderly patients undergoing cardiac surgery from January to December 2014 were enrolled in this study. The patients were randomly divided into observation group and control group. The control group entered the operating room after conventional tracheal intubation. After the observation group entered the operating room, tracheal plug 0.5% Povidone iodine was used in front of the tube, brushing teeth with an electric toothbrush for 3 min, rinsing for 2 min and rinsing for 1 min. Both groups were given routine oral care. The incidence of VAP was compared between the two groups. Results The incidence of VAP, length of hospital stay and duration of mechanical ventilation in observation group and control group were statistically significant (P <0.05). Conclusions 0.5% Povidone iodine before tracheal intubation can effectively reduce the oral organism and plaque index, reduce the incidence of VAP in elderly patients undergoing open heart surgery and reduce the duration of ventilation, duration of mechanical ventilation, duration of hospital stay And spend.