关键词: 口腔护理方法；气管插管；呼吸机相关性肺炎；网状Meta分析

Abstract: Objective: To evaluate the effect of fourteen oral hygiene methods on preventing Ventilator-Associated Pneumonia (VAP) systematically. Methods: The electronic portion of the search covered seven computer databases (PubMed, Cochrane library, Web of Science, EMbase, CBM, CNKI, Wanfang Data). Articles and reference lists were searched for Randomized Control Trials (RCTs) of oral hygiene methods for preventing VAP. The literature search covered articles that had been published from inception to June 2019. Results: A total of 26 RCTs involving 3 548 patients and 14 oral hygiene methods were included. The network Meta-analysis showed that, the incidence of VAP is higher in traditional swab scrubbing group than brushing the teeth+0.12% chlorhexidine [OR=3.00, 95% CI=(1.40, 7.30)], rinsing [OR=3.80, 95% CI=(1.10, 14.00)], brushing the teeth [OR=5.10, 95% CI=(1.80, 15.00)], brushing the teeth+0.12% chlorhexidine digluconate [OR=0.44, 95% CI=(0.23, 0.80)], brushing the teeth+rinsing [OR=0.22, 95% CI=(0.13, 0.37)], brushing the teeth+rinsing+0.12% chlorhexidine [OR=0.26, 95% CI=(0.09, 0.70)], brushing the teeth+toothpaste [OR=0.40, 95% CI=(0.21, 0.75)], Rinsing with nasopharyngeal cavity [OR=0.26, 95% CI=(0.10, 0.66)], brushing the teeth+toothpaste+toothpaste [OR=0.25, 95% CI=(0.08, 0.63)], brushing the teeth+toothpaste+deep pharyngeal suction [OR=0.21, 95% CI=(0.05, 0.81)], and all the differences had statistically significant (P<0.05). The result of rank probability showed that brushing the teeth+toothpaste+deep pharyngeal suction had the highest probability to be the optimum method. Conclusion: This study suggested that brushing the teeth + toothpaste + deep pharyngeal suction was the best method to prevent VAP. In future, researchers should pay attention to the economic costs, safety outcomes, nursing work difficulty and nurse workload of oral hygiene.

Key words: oral hygiene; endotracheal intubation; Ventilator-Associated Pneumonia; network Meta-analysis