儿童重症监护病房失禁相关性皮炎发生情况的调查研究

Incidence of incontinence-associated dermatitis in the pediatric intensive care unit

目的 描述某三级甲等医院儿童重症监护病房（PICU）失禁相关性皮炎的发生情况,并探讨其相关影响因素.方法 2016年9—12月,采用便利抽样法,选择某三级甲等医院儿童重症监护病房的268例住院患儿进行调查,采用患儿一般资料调查表、Braden Q压疮评估量表、儿科营养不良评估筛查工具（STAMP）、布里托斯大便分类法、失禁相关性皮炎严重程度评估量表（IADS）进行调查,采用秩和检验、Spearman秩相关分析和多元逐步回归分析进行统计分析.结果 失禁相关性皮炎发生率为36.2%,失禁相关性皮炎严重程度评估量表（IADS）得分为（1.63±3.54）分.Braden Q压疮评分与IADS评分呈负相关（r=-0.230,P〈0.05）,STAMP评分均与IADS评分呈正相关（r=0.204,P〈0.05）.多元逐步回归分析显示,大便类型、Braden Q压疮评分、是否水肿、年龄4个因素是失禁相关性皮炎严重程度的影响因素（P〈0.05）.结论 PICU住院患儿失禁相关性皮炎发生率较高,IADS得分较低,大便类型、Braden Q压疮评分、是否水肿、年龄与住院患儿失禁相关性皮炎严重程度有关.

Objective To describe the incidence of incontinence-associated dermatitis （IAD） in the pediatric intensive care unit （PICU） in a tertiary hospital, and to explore relevant influencing factors.Methods Totally 268 children in the pediatric intensive care unit in a tertiary hospital were selected by convenience sampling between September and December 2016 and investigated with the General Information Questionnaire, Braden Q Pressure Ulcer Scale, Screening Tool for the Assessment of Malnutrition in Pediatrics （STAMP）, Bristol Stool Scale and Incontinence-Associated Dermatitis Scale （IADS）. Then the data were analyzed by the rank sum test, Superman rank correlation analysis and stepwise multiple regression analysis.Results The incidence of IAD was 36.2%, and the IADS score was （1.63±3.54）. The Braden Q score was negatively correlated with the IADS score （r= -0.230,P〈0.05）, while the STAMP score was positively correlated with the IADS score （r=0.204,P〈0.05）. According to the multiple regression analysis, stool type, Braden Q score, edema and age were the influencing factors to the severity of IAD （P〈0.05）.Conclusions The PICU sees a high incidence of IAD, but a low IADS score. And stool type, Braden Q score, edema and age are related to the severity of IAD.