摘要目的 探讨口腔脱污染联合胃肠动力药物对预防老年人医院获得性下呼吸道感染(hospital-acquired lower respiratory tract infection,HALRTI)的有效性.方法 选择具有发生HALRTI高危因素的110例老年住院患者,随机分为干预组和对照组.干预组予西吡氯铵含漱液漱口(每次20 mL,2次/d),并口服莫沙比利片(每次5 mg,3次/d).两组下呼吸道感染发生率比较采用精确概率法(单侧),咽拭子培养阳性率与住院时间相关性采用Spearman秩相关检验,采用SPSS 12.0软件包进行统计分析.结果 干预组和对照组的HALRTI发生率分别为2.00%(1/50)和13.73%(7/51),差异有统计学意义(P=0.031).对照组咽拭子培养阳性率随着住院时间延长显著增高(r=0.450,P＜0.05),而干预组咽拭子培养阳性率则无显著增高(r=-0.023,P＞0.05).结论 西吡氯铵含漱液漱口联合莫沙必利口服可有效预防高危老年住院患者HALRTI的发生.

abstractsObjective To evaluate the clinical efficacy of oropharyngeal decontamination combined with gastrointestinal excitomotor in preventing hospital-acquired lower respiratory tract infection(HALRTI)in elderly inpatients. Methods Totally 110 elderly inpatients with high risks of HALRTI were randomized into intervention group and control group. Patients of the intervention group were administrated by cetylpyridinium chloride gargle twice daily for gargling(20 mL for each), combined with moshabili three times daily orally(5 mg for each). Exact Sig. l-sided was performed to compare the occurence of HALRTI,and Spearman test was performed to evaluate the correlation between positive rate of the phyarynx swabs and the hospitalized time. SPSS 12.0 software was used for statistical analyzing. Results Patients suffered from HALRTI were 1 case(2.00%)in intervention group and 7 cases(13.73%)in control group respectively,and the difference was of statistical significance(P ＜ 0.05). As hospitalized time went on, the positive rate of the phyarynx swabs microbial culture in the control group increased(r = 0.450, P ＜ 0.05), while the intervention group showed no significant change during the whole intervention time(r = -0.023, P ＞0.05). Conclusion The combined intervention of oropharyngeal decontamination with the gastrointestinal excitomotor may be beneficial to elderly inpatients with high risk of HALRTI in the prevention of HALRTI.