ICU肠内营养相关性腹泻患者失禁性皮炎危险因素分析

ICU Enteric Nurtrition Related Diarrhea Patients’ Incontinence-associated Dermatitis:An Analysis on the Risk Factors

目的:探讨重症监护病房(ICU)肠内营养相关性腹泻患者发生失禁性皮炎(IAD)的相关危险因素。方法:以2017年1月至2022年1月新乡市中心医院ICU住院发生肠内营养相关性腹泻的80例患者为研究对象,收集患者病例资料,根据是否发生IAD分为IAD组和非IAD组,采用单因素和多因素Logistic回归分析法分析影响IAD的危险因素。结果:80例肠内营养相关性腹泻患者中,22例(27.50%)发生IAD。单因素分析显示,IAD组和非IAD组患者在年龄、合并低蛋白血症、存在多重耐药菌、大便性状、腹泻时间、每日排便次数、APACHEⅡ评分、抗生素使用时间方面比较差异均有统计学意义(P<0.05);在性别、体质量指数(BMI)、合并高血压、合并糖尿病、是否建立人工气道方面差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,年龄、大便性状、腹泻时间及APACHEⅡ评分是影响ICU肠内营养相关性腹泻患者发生IAD的危险因素。结论:年龄大、水样便、长时间腹泻、APACHEⅡ评分高是影响ICU肠内营养相关性腹泻患者发生IAD的危险因素,临床应对这些患者进行早期监测及干预,以降低IAD发生风险。

Objective To analyse the risk factors of incontinence-associated dermatitis(IAD)of ICU patients with enteric nurtrition related diarrhea.Methods Enrolled 80 patients with above diarrhea in authors’hospital(2017-01-2022-01)into this sutdy:collect their case-data,then,according to with or without IAD divided them as IAD group and non-IAD group,further analyse IAD’s risk factors by using Logistic regression analysis,univariate/multi-variate.Results In the 80 cases,22 got IAD(27.50%),Univariate analysis showed age(1),associated with hypoproteinemia,existing multi-drug resistant microorganisms(MDRMs),stool characters(2),diarrhea time(3),defecation times/day,APACHEⅡscore ratings(4),and medication time of antibiotics there was statistical difference between the two groups(P<0.05);but in gender,BMI,accociated HP,complicated with DM,as well as with or without establishment of artificial airway there was no statsitcial difference(P>0.05).Multi-variate analysis showed(1),(2),(3)and(4)being risk factors influencing IAD.Conclusion Aged,watery diarrhea(stool),longer time of diarrhea,and high ratings of APACHEⅡscore are the risk factors influencing IAD happening,therefore,clinically,it should be early monitoring and intervention on patients,so as to reduce risk of IAD happening.