肠造口患者造口周围潮湿相关性皮肤损伤发生现状及影响因素分析

Analysis on the present situation and influencing factors of peristomal moisture-associated skin damage in 276 postoperative patients with fecal ostomies

目的 调查结直肠肿瘤术后肠造口患者造口周围潮湿相关性皮肤损伤(MASD)发生状况。 方法 采用便利抽样的方法,选择2016年3月至2017年12月在安徽省肿瘤医院伤口造口门诊就诊或院内外咨询会诊的276例肠造口患者(包括临时性造口和永久性造口)作为研究对象,采用自制一般情况调查表及造口自我护理能力量表对其进行调查。 结果 276例肠造口患者,其中结肠造口119例占43.1%,回肠造口157例占56.9%。存在造口旁潮湿相关性皮肤损伤的患者为92例,发生率33.3%,二分类Logistic回归分析显示,造口时间(P=0.004)、造口种类(P=0.009)、造口高度(P=0.001)、造口自我护理知识(P=0.012)及护理技能(P=0.002)是造口旁MASD发生的影响因素。 结论 肠造口患者潮湿相关性皮肤损伤发生较为普遍,应采取针对性措施,降低其发生率或及时予以干预。

Objective To investigate the occurrence of moisture-associated skin damage (MASD) around the stoma in patients with colorectal tumor after enterostomy. Methods Using convenience sampling method, during March 2016 to December 2017 in Anhui Provincial Cancer Hospital wound and stoma outpatient, choose 276 patients with enterostomy (including temporary enterostomy and permanent enterostomy), using self-made general questionnaire and ostomy self nursing competence scale to investigate them. Results Totally 276 cases of enterostomy patients, including 119 cases (43.1%) underwent colostomy, 157 cases ileum ileostomy (56.9%). There were 92 cases (33.3%)of patients with MASD , the binary classification Logistic regression analysis showed that enterostomy time (P = 0.004), the type of enterostomy (P = 0.009), height of enterostomy (P = 0.001), enterostomy self-care knowledge (P= 0.012) and nursing skills (P = 0.002) were MASD influence factors. Conclusion The present study shows that MASD is widespread in patients with enterostomy, and targeted measures should be taken to reduce its incidence or to intervene in time.