心脏介入术后使用弹力胶布引起医用粘胶剂相关性皮肤损伤的现状分析

The current situation of medical adhesive-related skin injury caused by using the elastic tape of patients after cardiac intervention

目的调查心内科行心脏介入术后使用弹力胶布加压包扎后引起医用粘胶剂相关性皮肤损伤(medical adhesive-related skin injury,MARSI)的发生现状并分析其影响因素。方法横断面调查某三级甲等医院心内科2018年8-10月行心脏介入手术后使用弹力胶布加压包扎的163例患者,分析MARSI的发生现状及影响因素。结果163例患者中,发生MARSI 57例(35.0%),按MARSI损伤类型分为表皮剥脱15例(26.3%),皮肤撕裂伤8例(14.0%),张力性水疱17例(29.8%),刺激性接触性皮炎10例(17.5%),过敏性皮炎7例(12.3%)。Logistic回归分析显示,患者年龄(P=0.014,OR=1.065),医生撕除粘胶手法(P=0.001,OR=4.502),患者BMI(P=0.024,OR=7.103),胶布粘贴部位(P=0.044,OR=2.657)为MARSI发生的独立危险因素。结论心脏介入术后使用弹力胶布加压包扎后引起的MARSI发生率高,患者年龄越大、医生撕除手法不当、患者消瘦、胶布粘贴于前胸及左肩部为MARSI发生的独立危险因素,医护人员应针对其高危因素采取预见性护理,以降低MARSI的发生。

Objective To investigate the current situation of medical adhesive-related skin injuries(MARSI)caused by using the elastic tape of patients after cardiac intervention and analyze its risking factors.Methods A cross-section study was conducted among 163 patients undergoing cardiac intervention and pressure dressing between August and October 2018.The prevalence of MARSI was calculated and risk factors were analyzed.Results Among the 163 patients,35.0%(57/163)suffered from MARSI,with 15(26.3%)of skin stripped,8(14.0%)of skin laceration,17(29.8%)of tension blister,10 of(17.5%)irritant contact dermatitis,and 7(12.3%)of allergic dermatitis.Binary logistic analysis identified four independent risk factors for MARSI including age(P=0.014,OR=1.065),the way doctors getting rid of the tape(P=0.001,OR=4.502),the nutritional status(P=0.024,OR=7.103),the site to apply the elastic tape(P=0.044,OR=2.657).Conclusion MARSI is of high prevalence among patients using the elastic tape after the cardiac intervention.The independent risking factors are age,wrong way to get rid of the tape,applying them on the chest and left shoulder.Therefore,corresponding nursing should be conducted to low the occurrence of MARSI.