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0.12% 클로르헥시딘을 적용한 구강간호가 인공호흡기 관련 폐렴(VAP)과 구강상태에 미치는 효과

The effect of oral care with 0.12% chlorhexidine for VAP and oral health in critically ill patients

고미숙|김진희|최은희
사단법인 인문사회과학기술융합학회 (The Convergent Research Society Among Humanities, Sociology, Science, and Technology)|2017.03|예술인문사회 융합 멀티미디어 논문지 (Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology)|제7권 제3호|pp. 461-476|DOI 10.35873/ajmahs.2017.7.3.046

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참고문헌

키워드

클로르헥시딘chlorhexidine구강간호oral careVAP인공호흡기 관련 폐렴critically ill patient중환자구강사정도구Oral Assessment Guide (OAG)
주제분류학제간연구

초록

본 연구는 0.12% 클로르헥시딘액을 적용한 구강간호 중재가 중환자실 입원환자의 VAP 발생과 구강상태 변화에 미치는 효과를 확인하고자 하였다. 연구결과 인공호흡기 관련 폐렴(VAP)의 발생률은 두 군간에 통계적으로 유의한 차이를 보여(p=.018) 가설 1은 지지되었다. 시간경과에 따른 그룹 간 구강상태 점수(OAG scores)는 통계적으로 유의한 차이를 나타내지 않아(F=1.838, p=.639) 제 2가설은 기각되었다. 실험군 중 VAP이 발생한 군과 발생하지 않은 군으로 구분하여 구강상태 점수(Item scores of OAG)의 차이를 비교해 본 결과, 구강사정도구의 하위개념(Item) 중 구강점막(F=3.816, p=.022)과 잇몸(F=5.220, p=.007) 항목의 점수에서 통계적으로 유의한 차이가 있는 것으로 나타나 제 3가설은 부분적으로 지지되었다. 이상의 결과로 볼 때, 0.12% 클로르헥시딘을 이용한 구강간호는 인공호흡기를 적용한 중환자의 VAP 예방과 구강상태 개선에 효과적인 구강간호 방법인 것으로 생각된다. 또한, 본 연구의 결과 VAP과 유의한 구강사정 항목이 구강점막과 잇몸상태로 확인되어 이 두 가지의 구강사정만으로도 VAP 발생을 예측할 수 있다는 가능성을 제시하고 있다.

Abstract

The aim of this study was to evaluate the effectiveness of 0.12% chlorhexidine gluconate (CHX) oral care in the prevention of VAP and oral health status in critically ill adult mechanically ventilated patients in ICUs. The incidence of VAP was significantly higher in the control group than in the 0.12% CHX group (9.7% vs 33.4%, p=.018). There was no significant difference in oral health status score between the two groups (F=1.838, p=.639). Oral health score of the VAP group and non-VAP group in 0.12% CHX group compared to the difference between the item scores of OAG, the oral mucosa (F=3.816, p=.022) and gingiva score (F=5.220, p=.007) were a statistically significant difference in the scores of the items. The finding of the present study, that oral care with 0.12% CHX is considered to be an effective method for preventing VAP and improving oral health status in critically ill patients who receive mechanical ventilation.

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