The randomized trial for Effect of oral health care on the recovery from surgery in elderly patients

口腔保健对老年患者手术恢复影响的随机试验

• 批准号: 14571943
• 负责人: YOSHIHARA Akihiro
• 金额: $ 1.66万
• 依托单位: Niigata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14571943/
• 关键词: Postoperative oral care; Elderly people; Respiratory dysfunction; 術後高齢者; 口腔ケア; 肺雑音; 無作為化臨床研究; 生体ガス

The purpose of the present study was to clarify the effectiveness of postoperative oral care, including toothbrushing, denture cleaning and tongue cleaning following digestive tract surgery.The subjects were 30 consenting elderly patients aged between 60 and 98 years (mean, 76.9±7.8 years) who underwent digestive tract surgery. Using a systematic sampling method, subjects were divided into two groups : an intervention group, and a control group. In the intervention group, the following oral care was provided daily over a five-minute period between 7 and 8 in the morning : gargling with povidone iodine, tooth brushing, denture cleaning using a special brush, and tongue cleaning using a tongue brush. In the control group, the subjects only gargled with povidone iodine. The number of remaining teeth, denture usage, sensation of dry mouth, dental calculus deposition, tooth mobility, and volatile sulfur compounds were compared between the intervention and control groups. Then, changes in vo … More latile sulfur compounds, pulmonary sounds, pharyngeal bacteria and fever from the time of operation to five days after surgery were compared between the intervention and control groups.The incidence of abnormal pulmonary sounds for the intervention group increased from 6.6 to 13.0% (an increase of 6.4%), while that for the control group increased from 0 to 26.6% (p<0.05, Fisher's direct probability test). The average number of bacterial species per subjects for the control group was 3.64±1.34 preoperatively and 3.50±1.74 postoperatively, whereas that for the intervention group was 3.08±0.95 preoperatively and 2.62±0.65 postoperatively. In the intervention group, there was a significant decrease in the number of bacterial species (p<0.05,t-test). The average degree of change (ng/10ml) in hydrogen sulfide levels from before surgery to five days after surgery for the intervention and control groups was -2.93±8.08 and 0.81±4.86,respectively ; for methyl mercaptan, -1.10±2.30 and 0.40±1.72,respectively ; for dimethyl sulfide -0.36±1.30 and 0.16±1.60,respectively. When compared to the control group, the level of each volatile sulfur compound markedly decreased for the intervention group, and there was a statistically significant difference in methyl mercaptan (p<0.001,t-test).Since anaerobic bacteria are involved in the production of volatile sulphur compounds in the oral cavity, the volatile sulphur compounds concentration is believed to reflect the number of bacteria in the mouth. The findings in the study clarify that postoperative oral care in elderly patients undergoing digestive tract surgery lowers the number of bacterial species found in the oral cavity and alleviates respiratory dysfunction. Less

本研究的目的是阐明术后口腔护理的有效性，包括刷牙，义齿清洁和舌头清洁消化道手术后，受试者是30例年龄在60 - 98岁（平均，76.9±7.8岁），同意接受消化道手术的老年患者。采用系统抽样方法，将受试者分为两组：干预组和对照组。在干预组中，每天早上7点至8点提供以下口腔护理，时间为5分钟：用聚维酮碘漱口，刷牙，使用特殊刷子清洁义齿，使用舌刷清洁舌头。在对照组中，受试者仅用聚维酮碘漱口。比较干预组和对照组的剩余牙齿数量、义齿使用情况、口干感、牙结石沉积、牙齿活动度和挥发性含硫化合物。然后，vo的变化 ...更多信息 比较干预组与对照组从手术时到术后5天的含硫化合物、肺音、咽部细菌和发热情况，干预组异常肺音的发生率从6.6%增加到13.0%（增加6.4%），而对照组从0增加到26.6%（p<0.05，Fisher直接概率检验）。对照组术前平均每例受试者的细菌种类数为3.64±1.34，术后为3.50±1.74，而干预组术前平均每例受试者的细菌种类数为3.08±0.95，术后为2.62±0.65。在干预组中，细菌种类的数量显著减少（p<0.05，t检验）。从术前到术后5天，干预组和对照组硫化氢水平的平均变化程度（ng/10 ml）分别为-2.93 8. 08和0.81± 4.86，甲基硫醚分别为-1.10 2. 30和0.40± 1.72，二甲基硫醚分别为-0.36 1. 30和0.16± 1.60。当与对照组相比时，干预组的每种挥发性硫化合物的水平均显著降低，并且在甲基硫化合物中存在统计学显著差异（p<0.001，t检验）。由于厌氧菌参与口腔中挥发性硫化合物的产生，因此认为挥发性硫化合物浓度反映口腔中细菌的数量。研究结果表明，接受消化道手术的老年患者的术后口腔护理可降低口腔中发现的细菌种类数量，并减轻呼吸功能障碍。少