造口周围皮肤标准护理数字化的临床探讨

Clinical discussion on digitalization of stand ard nursing on skin around the stoma

目的寻找能准确反映造口周围皮肤状况且可提供专业指导客观的、标准的方法。方法借助DET评估量表和AIM造口周围皮肤指南，使用已研发的数字化软件，对膀胱造口恢复期出现周围皮肤损伤的患者，通过手机拍照，搜集皮肤图像，将图像输入图片分析软件结合患者病情进行评估，计算机计算后给予专业护理建议，以对比不同专业人员的护理评估与数字化软件的使用者，使用2款智能手机对造口周围皮肤损伤的评估护理情况间有无显著差异性：并对比使用前后皮肤症状发生率。结果造口周围皮肤标准治疗数字化评估软件系统与造口治疗师依据DET评估量表对D（颜色改变）、E（浸渍，溃疡）、T（组织增生）三种症状给出的分值进行Kendall协调系数W检验（w=0．9020，x^2=184．0580，P〈0．05），检验结果显示该系统评分与专业造口治疗师评分具有统一性；使用前皮肤损伤症状总发生率为100．00％，使用后发生率为61．54％（x^2=24．76，P〈0．01）。结论利用造口周围皮肤标准治疗数字化评估系统可对造口皮肤行标准化评估．并可给出专业建议和系统指导，减少人为误差，改善损伤皮肤的护理有效性。

Objective To explore a objective and standard method to accurately reflect skin condition around the stoma and to provide professional guidance. Methods The conditions of patients with surrounding skin injury at recovery stage after cystostomy were evaluated by mobile phone photographing, skin images collecting, and images inputting to a de- veloped digitization software based on DET scale and AIM guidance for skin around stoma. Professional nursing advices were given after calculation by computers, to compare the differences between evaluation results given by nursing professionals and software users using two types of smartphones. And the incidence rates of skin symptoms before and after application were compared. Results The scores of D （color changes）, E （infiltration/ulcer）, and T （tissue proliferation） given by the standard treatment on skin around the stoma digitalized evaluation software system and by the stoma therapists based on DET scale were tested by Kendall cooperation index W test （W=0.9020, x^2=184.0580, P〈0.05）, and the results showed consistency between results by the software system and those by professional stoma therapists. The overall incidence rate of skin injury before application was 100.00%, which was only 61.54% after application （x^2=24.76, P〈O.O1）. Conclusion Standard treatment on skin around the stoma digitalized evaluation software system can perform standard evaluation on skin around the stoma, give professional advices as well as systematic guidance, reduce personal errors, and improve nursing efficacy on injured skin.