重症脑卒中患者并发失禁相关性皮炎的影响因素研究

A study on influencing factors of incontinence-associated dermatitis complication to severe stroke patients

目的分析重症脑卒中患者并发失禁相关性皮炎(IAD)的影响因素,为IAD防治提供依据。方法收集125例重症脑卒中患者临床资料,根据住院期间患者有无IAD,分为IAD组和非IAD组,分析患者的性别、年龄、昏迷、体温、BMI、合并慢性病、神经功能(NIHSS)评分、卒中类型、营养和免疫等因素与并发IAD的关联性。结果 125例重症脑卒中患者中,30例并发IAD,占24.00%。其中轻度20例,中度7例,重度3例。多因素Logistic回归分析显示,年龄≥60岁(OR=7.515,95%CI:2.369~21.454)、体温≥38℃(OR=5.225,95%CI:2.612~10.774)、NIHSS评分≥12分(OR=3.467,95%CI:1.455~7.767)、出血性脑卒中(OR=0.596,95%CI:0.387~0.895)、低蛋白血症(OR=8.120,95%CI:3.574~27.644)是IAD发生的影响因素。结论高龄、发热≥38℃、NIHSS评分≥12分、缺血性脑卒中、低蛋白血症可能是重症脑卒中患者并发IAD的危险因素,应采取针对性的干预措施预防IAD发生。

Objective To explore the influencing factors of incontinence-associated dermatitis（ IAD） complication to severe stroke patients,and to provide basis for prevention of IAD. Methods Clinical data of 125 severe stroke patients was collected,and was grouped into IAD group and non-IAD group according to with or without complicated with IAD.Correlations of IAD and gender,age,obfuscation,temperature≥38 ℃,BMI,complicated with chronic disease,NIHSS score,stroke type,nutrition,immunity were analyzed. Results There were 30 of 125 severe stroke patients complicated with IAD,and the incidence of IAD was 24. 00%,with 20 mild cases,7 moderate cases and 3 severe cases. Logistic aggression suggested that age（ OR = 7. 515,95% CI： 2. 369-21. 454）,temperature（ OR = 5. 225,95% CI： 2. 612-10. 774）,NIHSS score（ OR = 3. 467,95% CI： 1. 455-7. 767）,stroke type（ OR = 0. 596,95% CI： 0. 387-0. 895）,hypoproteinenia（ OR = 8. 120,95% CI： 3. 574-27. 644） were influencing factors of IAD. Conclusion Senility,fever≥38 ℃,NIHSS score ≥12,cerebral arterial thrombosis,hypoproteinemia could be risk factors of complication with IAD among severe stroke patients,and preventive interventions should be taken to reduce the risk of IAD.