医用贴膜在居家腹膜透析患者出口处护理中的应用

Application of a medical film for exit site care in home-based peritoneal dialysis patients

目的探讨医用贴膜在居家腹膜透析患者出口处护理中的应用效果。方法选取在南方医科大学珠江医院肾内科住院行外科手术腹膜透析置管的患者155例,术后2周术部伤口拆线后,试验组长期使用医用贴膜,对照组长期使用肛门造口袋进行沐浴前出口处保护。比较2组患者对沐浴保护出口处工具的满意度及出口处感染发生率。结果试验组与对照组对使用保护装置满意度更高(92.2%比67.9%,χ^2=14.252,P<0.001),更少发生浸湿(0比37.2%,χ^2=35.217,P<0.001),总体出口处感染比例更低但无统计学差异(3.9%比10.3%,χ^2=2.377,P=0.123),校正沐浴频次后试验组出口处感染发生例数低于对照组(χ^2=5.164,P=0.023)。结论腹膜透析患者使用医用贴膜,可增加患者沐浴的舒适度及意愿,降低出口处感染率。

Objective To investigate the effectiveness of a medical film for exit site care in home-based peritoneal dialysis (PD) patients. Methods A total of 155 patients undergoing PD tube placement surgery at the Department of Nephrology, Zhujiang Hospital of Southern Medical University were enrolled in this study. After two weeks when sutures have been removed, a medical film was used in experimental group, and the bag for anal ostomy patients was used only during bath in control group. The satisfaction of exit site protection and the incidence of exit site infection were compared between the two groups. Results There were a higher satisfaction (92.2% vs. 67.9%,χ^2=14.252, P<0.001) and less wetness at exit site (0% vs. 37.2%,χ^2= 35.217, P<0.001) in experimental group than in control group. Exit site infections was lower in experimental group than in control group but without statistical significance (3.9% vs. 10.3%,χ^2=2.377, P=0.123);it became statistically significant after adjustment of the percentage with bath frequency (χ^2=5.164, P=0.023). Conclusion The use of the medical film for exit site care increased the comfort feeling and decreased the obstacle to bath and exit site infection.