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.
Objective To explore the type and frequency of oral care practice in intensive care units (ICUs) in Mainland China, and to provide evidence and suggestions for improving oral care practice. Methods Three survey methods, including mailing questionnaires to ICUs of Grade 3A hospitals, consulting experts in this field and visiting accessible ICUs, were used to survey current oral care practice in Mainland China. Results A total of 184 questionnaires were given to the subjects, of which 79 effective ones were collected, and the response rate was 42.93%. All 79 respondents considered oral care very unimportant, and 98.7% of the ICUs performed oral care in different ways. Currently, the cotton ball wipe-off method was the most frequently used for oral care (62.5%), with an average (9.1± 5.1) min per time, twice or three times daily. The mouthwashes often used were saline (76.1%), solutions containing sodium bicarbonate (22.8%), furacilin (13.9%), and hydrogen dioxide (13.9%). Conclusion The oral care practice for the critically-ill patients in ICUs of China is unsatisfactory, although it is perceived as an important item in nursing care. More evidence–based training should be given and it is necessary to establish a national oral care guideline for critically-ill patients.
Objective To assess the evidence of Cochrane systematic reviews relating to oral hygiene care. Methods Issue 3, 2008 of The Cochrane Library was searched for systematic reviews relating to oral hygiene care. Results Four systematic reviews with the forty-five randomized controlled trials (RCTs) were included. The methods of forty-five studies were of lower quality with high risk of various biases. Conclusion There is insufficient evidence to support oral hygiene care. The overall quality of RCTs about oral hygiene care is generally low. Analysis of the included trials shows some trials have no clear description of randomization methods, allocation concealment, sample size calculation, and intention-to-treat analysis. To improve the quality of reporting of RCTs, Clinical Trial Registration and Revised consolidated standards of reporting trial (CONSORT) statement should be introduced as guidelines into the trial design.
【摘要】 目的 探讨口服百草枯中毒患者口腔护理的方法及早期护理的临床意义。 方法 2009年1月-2010年3月，采用半随机方法将62例白草枯中毒患者按中毒时间的长短分A组（中毒时间lt;3 d，n=32）、B组（中毒时间gt;3 d，n=3），比较两组患者口腔溃疡的治愈率、并发症发生状况，分析早期口腔护理的必要性。 结果 A组患者百草枯所致的口腔黏膜损害明显减轻，并发症发生率降低，为改善预后提供了条件，显示了早期加强口腔护理的成效。 结论 重视百草枯早期口腔护理，能够减轻口腔糜烂溃疡痛苦，减少并发症，提高患者生活质量。【Abstract】 Objective To investigate the clinical significance of early oral care for paraquat-poisoned patients. Methods A quasi-randomized controlled trial was used. A total of 62 paraquat-poisoned patients (from January 2009 to March 2010) were divided into experimental group and control group in order to compare the healing rate of oral ulcer, complications and the necessity of early oral care between the two groups. Results The oral mucosa lesions in experimental group obviously alleviated and the complications decreased. The effective early oral care provided the very favorable conditions for better prognosis. Conclusion The early oral care for paraquat-poisoned patients could relieve the pain of oral ulcer, reduce the complications and improve patient′s life quality.
ObjectiveTo observe the effect of compound chlorhexidine gargle wash care for patients after radical surgery of tongue cancer. MethodsBetween January 2013 and March 2014, 40 patients with tongue cancer who underwent radical surgery without radiation therapy or chemotherapy before operation were selected and randomly divided into compound chlorhexidine giuconatie gargle solution group (intervention group, n=19) and traditional oral care group (control group, n=21). Then we compared the two groups in terms of bacterial colony number, oral cavity cleanness, incidence rate of bad breath and oral ulcer. ResultsBefore intervention, there was no significant diTherences between the two groups in the number of bacterial colony, oral cavity cleanness or oral odor (P>0.05). After treatment, the bacterial colony number and incidence of oral ulcer in the intervenient group were significantly lower, and oral odor was slighter than that of the control group (P<0.05). Oral cavity cleanness between the two groups was not significantly different (P>0.05). ConclusionCompound chlorhexidine gargle wash care for patients after radical surgery of tongue cancer was better than the traditional treatment in terms of bacterial colony number, incidence rate of bad breath and oral ulcer. It is worth clinical popularizing.
Ischemic stroke can lead to disruption in the oral ecology and an overgrowth of pathogenic bacteria, resulting in periodontal disease. Meanwhile, the aspiration and pulmonary infection resulted from dysphagia can increase the unfavorable prognosis. Some studies have found that there exist oral bacteria in the thrombus in myocardial infarction and ischemic stroke patients, showing that oral flora might be associated with thrombus and stroke-associated pneumonia. There are few high quality clinical studies or evidence-based guidelines. Priority should be given to high quality research that provides oral care standards, and incorporating oral care into future stroke pathways to improve the prognosis.