关键词: 肺炎, 呼吸机相关性；复方氯己定含漱液；声门下冲洗；致病菌；耐药性

Abstract: Background　The establishment of artificial airway damages the physiological protective barrier of oropharynx and lower respiratory tract.A large number of bacteria accumulating between subglottic and tracheal cannula balloon is an important source of pathogenic bacteria of ventilator-associated pneumonia（VAP）.Compound chlorhexidine gargle could inhibit bacterial adhesion and growth in oral cavity and kill many pathogenic bacteria.Objective　To evaluate the effect of subglottic secretion drainage with compound chlorhexidine gargle on VAP.Methods　It was a prospective randomized controlled study.From January 2016 to August 2018，120 patients receiving mechanical ventilation in EICU and ICU of the Second Affiliated Hospital of Nanchang University were randomly divided into A group and B group（60 patients in each group）.Patients in B group was rinsed with compound chlorhexidine gargle every 6 hours and continuous negative pressure aspiration while patients in A group rinsed with normal saline.The end point of observation was the 14th day after the beginning of mechanical ventilation.Incidence of VAP，lengths of mechanical ventilation，ICU stay，time of using antibiotics，colonies of pathogenic bacteria in subglottic secretion，bacteria and drug resistance in lower respiratory tract of VAP patients between two groups were compared.Results　The incidence of VAP，lengths of mechanical ventilation time，ICU stay and time of using antibiotics in B group were significantly lower than those in A group（P<0.05）.The subglottic secretion bacterial colonies in B group were significantly lower than that in A group on 3，6，9，12 d（P<0.05）.The rate of Gram-negative bacilli of VAP patients in B group was significantly lower than that in A group（P<0.05），in which the MDR，XDR rate of Acinetobacter baumannii was significantly lower（P<0.05）.Conclusion　Subglottic secretion drainage with compound chlorhexidine gargle in patients with mechanical ventilation could significantly reduce the incidence of VAP，lengths of mechanical ventilation，ICU stay，time of using antibiotics，the number of colonies of subglottic secretion and Gram-negative pathogenic bacteria and drug resistance of VAP.It could be used as a preventive and therapeutic measure for VAP.

Key words: Pneumonia, ventilator-associated；Compound chlorhexidine gargle；Subglottic secretion drainage；Pathogenic bacteria；Drug resistance