加護病房神經外科氣管內管病患口腔清潔方法與口臭之相關性探討

An investigation of Oral Malodor and Oral Care Practices in the Patients with Oral Endotracheal Tube at a Neurosurgery Intensive Care Unit.

吳芳瑜(Fang-Yu Wu)

指導教授 ： 蔡吉政

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2009年)

摘要

背景：加護病房神經外科氣管內管患者口腔內發出令人難受的氣味，其口臭一直是臨床上難以解決的問題。
研究目的：藉此分析加護病房神經外科患者口臭之影響因子；再介入三合一口腔清潔法(刷除舌苔、刷牙及漱口水)，來探討病患口腔內揮發性硫化物及口臭感官檢測值降低的程度。
研究方法：受測者共34名，分別以主觀的口臭感官檢測法與客觀的氣體相層分析法來測量口臭感官指數及口內揮發性含硫化物濃度，並以描述性統計及複迴歸分析來探討病患基礎資料、舌苔指數及口臭之間的關連性。隨機挑選26名受測者完成實驗，經口腔清潔前後口臭程度及舌苔指數的資料收集，由Wilcoxon Sign-Rank統計法分析各實驗期間之差異性。
研究結果：實驗結果顯示舌苔指數及口腔內硫化氫、甲硫醇及整體揮發性硫化物濃度與口臭感官指數有顯著相關；由每天口腔清潔一次經兩天後能比三合一口腔清潔法介入前的口臭值能降低一半以上。
結論：本研究顯示三合一口腔清潔確實能有效降低口內揮發性含硫化物濃度及口臭感官指數，建議加護病房神經外科患者盡可能每天至少12小時執行一次口腔清潔，改善口臭效果的持久性會更長。
關鍵詞：口臭、口腔護理、揮發性含硫化物

關鍵字

口臭 ； 口腔護理 ； 揮發性含硫化物

並列摘要

Background：The painful smell is called the halitosis in neurosurgery patients with oral endotracheal tube of intensive care unit .The halitosis problem has been difficult to solve all the time.
Purpose：The aim of this study to investigate relevant factors of the halitosis and explore the effect of triple oral hygiene practice (mechanical tongue cleaning, tooth brushing and Scodyl?? mouthwash) on the levels of volatile sulphur compounds(VSCs).
Materials and Metholds: Thirty-four patients with oral endotracheal tube at a neurosurgery intensive care unit with heavy tongue coating were assessed for oral malodor. Oral malodor was evaluated by measuring the levels of volatile sulfur compounds using Oral Chroma?? and the organoleptic test score. Twenty-six participants were randomly selected for the subsequent experiments: triple oral hygiene practice consistinf of mechanical tongue cleaning、tooth brushing and chlorhexdine (Scodyl??) mouthwashing.
Results：Significant correlations were observed between the OLT and H2S, CH3SH, TCS and VSCs level. Once a day after the triple oral hygiene could reduce over one half of halitosis than baseline.
Conclusion：In this study, we found that mouth care was slightly more effective in reducing VSC levels of oral malodor. These findings suggest that triple oral hygiene proctice may be better to reduce malodor and VSCs for neurosurgery intensive care unit patients in neurosurgery intensive care unit twice every day.
Keyword：halitosis, oral hygiene, volatile sulfide compounds

並列關鍵字

halitosis ； oral hygiene ； volatile sulfide compounds

參考文獻

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