一种结构化皮肤干预方案在ICU大便失禁患者中的应用

Application of a structured skin care regimen on the patients with fecal incontinence in ICU

目的 探讨《大便失禁患者结构化皮肤干预方案》对ICU大便失禁患者失禁相关性皮炎（Incon-tinence-Associated Dermatitis,IAD）的护理效果.方法 选取ICU大便失禁患者作为研究对象,对照组和干预组各72例,对照组实施大便失禁及IAD护理常规,干预组实施《大便失禁患者结构化皮肤干预方案》,观察两组患者IAD发生率、严重程度、护理费用及护理时间.结果 干预组IAD发生率明显低于对照组,差异有统计学意义（P〈0.05）;干预组IAD严重程度得分低于对照组,差异有统计学意义（P〈0.05）;干预组大便失禁患者和发生IAD的患者费用明显低于对照组,差异均有统计学意义（均P〈0.05）,干预组未发生IAD的患者费用与对照组相比,差异无统计学意义（P〉0.05）;干预组大便失禁患者及发生IAD的患者护理时间与对照组相比,差异无统计学意义（P〉0.05）.结论 《大便失禁患者结构化皮肤干预方案》能显著降低ICU大便失禁患者IAD发生率及严重程度,降低大便失禁及IAD患者的护理费用,减轻患者和社会的负担.

Objective To explore the nursing effects of＂ structured skin-care regimen＂ on the incontinence-associated dermatitis of ICU patients with fecal incontinence. Methods A total of 144 patients with fecal incontinence in ICU were chosen as the research objects and were divided into the control group and the intervention group, 72 cases of each group. The control group received routine care of incontinence-associated dermatitis, and the intervention group were given the＂ structured skin-intervention program for patients with fecal incontinence＂. Rate of incontinence-associ-ated dermatitis and its severity, nursing duration and care cost were compared between the control group and the inter-vention group. Results The incidence rate of IAD of the intervention group was significantly lower than that of the con-trol group, and the difference was statistically significant （ P〈0. 05 ） . The severity score of IAD of the intervention group was lower than that of the control group, and the difference was statistically significant （P〈0. 05）. The costs of patients with fecal incontinence and IAD of the intervention group were significantly lower than those of the control group, and the differences were statistically significant （ P〈0. 05 ） . There was no significant difference in the cost of IAD in the intervention group compared with the control group （ P〉0. 05 ） . There was no significant difference in the nursing time between patients with fecal incontinence and IAD in the intervention group compared with the control group （ P〉0. 05 ） . Conclusion Structured skin-care regimen can obviously reduce the occurance rate of incontinence-associ-ated dermatitis and its severity, decrease care cost of fecal incontinence patients with incontinence-associated dermatitis and reduce the burden of patients and the society.