【摘要】 目的　为了有效地提高住院病人口腔护理质量 ,对国内有关文献进行系统复习 ,并进行系统评价。方法　以口腔护理为检索词 ,对中文电子数据库进行检索 ,截止日期 2 0 0 4年 4月 30日。同时手检寻找可能漏查的文献。 4位作者参与文献筛选、资料提取和质量评价对合格研究进行描述或Meta分析。结果　有 2 8篇文献符合纳入标准 ,其中 6篇符合排除标准。质量评分为B有 7个试验 ,其余 15个被评分为C ,其中随机对照试验 11个 ,半随机对照试验 4个。共纳入研究对象 2 372例 ,包括各科危重病人需口腔护理者、接受气管插管患者、恶性肿瘤接受化学治疗和放射治疗的患者和外科手术术后患者。与纳入研究的作者联系 ,有 6位RCT作者回复 ,其中 4位提供了随机方法补充信息。分析结果显示 ,传统的口腔护理方法适用于生活不能自理的重危病人 ,对意识清醒、上肢有一定活动能力的病人 ,可以使用刷牙漱口的方法进行口腔护理 ;茶水、牙膏等作为口腔护理的辅助材料使用是经济、安全和有效的 ;按照口腔 pH测量值选择药物可以提高口腔护理效果 ,特别是口腔处于酸性环境时使用碳酸氢钠漱口液 ,可以有效减少真菌感染 ;含茶多酚的制剂具有良好的口腔卫生效果 ,特别是在肿瘤病人接受放射线、化学药物治疗时可作为防治口腔粘膜炎症的首选更多还原

【Abstract】 Objective A systematic review was conducted based on the domestically published literature for improving the quality of oral nursing care.Methods The terms “oral nursing care”, “oral hygiene care”, “mouth care” were used to search related studies in Chinese databases (up to April 30, 2004) along with handsearching additional studies. Four authors screened and selected the studies, appraised the methodological quality and extracted data from these selected studies. The results were presented by description or Meta-analysis. Results A total of 28 studies were identified, of which 6 were excluded. The methodological quality varied among the studies, 7 scored as B, 15 as C (11 randomized controlled trials, 4 quasi-randomized trials). A total of 2 372 patients were observed including some were critically ill, or intubated, or receiving radiotherapy or chemotherapy or undergoing surgical operations.Six authors of RCT replied and four of them provided more information on methods of randomization. Data analysis revealed that traditional oral nursing procedure was suitable for the severely sick patients who could not take self-care. Brushing and gargling were suitable for conscious patients who could use their hands. Tea and toothpaste were safe, economical and convenient oral nursing agents. Oral pH was a useful index for the selection of oral nursing agents and mouthwashes. A gargle containing sodium bicarbonate was used in the acidic oral environment and reduced fungal infection. The mouthwash with tea polyphenols had good effect for oral health, and might be as the first choice for prophylaxis of stomatitis induced by radiotherapy and/or chemotherapy. Some mouthwashes developed by Chinese herbs improved oral health efficiently. Some disinfectants with good safety and low toxicity might be used as supplementary agents in oral nursing care. Conclusions Oral nursing care procedures have improved the efficiency of oral care. But the conclusion should be verified by more, well designed randomized controlled trials involving a collaborative multidiscipliary health care professionals. Oral nursing care practice needs to be evidence based.更多还原