影响早产儿PICC置管部位医用敷料相关性皮肤损伤的危险因素分析

Analysis of Risk Factors Affecting Medical Dressing Related Skin Injury in PICC Placement of Premature Infants

目的探讨影响早产儿经外周静脉穿刺中心静脉置管(PICC置管)部位医用敷料相关性皮肤损伤的危险因素。方法方便选取2018年1月—2019年6月在该院行PICC置管的202例早产儿,随机数字表法将早产儿分为观察组和对照组。对照组早产儿采取常规方式更换敷料,观察组早产儿采取安尔碘消毒后0角度撕除更换敷料,比较两组患儿皮肤损伤情况。结果观察组机械性皮肤损伤率0.97%、潮湿相关性皮肤损伤率0.97%、皮炎发生率1.94%、毛囊炎发生率0.97%均低于对照组的12.12%、8.08%、10.10%、9.09%,差异有统计学意义(χ^2=6.227、4.441、6.014、7.074,P=0.013、0.035、0.014、0.008);观察组静脉炎发生率9.71%明显低于对照组的20.20%,差异有统计学意义(χ^2=4.396,P=0.036),两组静脉炎分级比较差异无统计学意义(P>0.05)。结论早产儿PICC置管后采取安尔碘消毒后0角度撕除方式更换敷料可减少皮肤损伤和静脉炎发生,有利于促进患儿恢复。

Objective To investigate the risk factors of medical dressing-related skin injury at the site of peripheral venous central venous catheterization(PICC catheterization)in premature infants.Methods 202 premature infants who underwent PICC catheterization in the hospital from January 2018 to June 2019 were conveniently selected.The preterm infants were divided into observation group and control group by random number table method.The premature infants in the control group were replaced with conventional dressings,and the premature infants in the observation group were disinfected with aner iodine,and then the dressings were torn off at 0 angle to compare the skin damage of the two groups.Results The mechanical skin damage rate of the observation group was 0.97%,the moisture-related skin damage rate was 0.97%,the dermatitis rate was 1.94%,and the folliculitis rate was 0.97%,all were lower than the control group's 12.12%,8.08%,10.10%,9.09%,the difference was statistically significant(χ2=6.227,4.441,6.014,7.074,P=0.013,0.035,0.014,0.008);the incidence of phlebitis in the observation group was 9.71%significantly lower than that of the control group(20.20%),the difference was statistically significant(χ2=4.396,P=0.036),there was not statistically significant difference in phlebitis grading between the two groups(P>0.05).Conclusion After PICC catheterization in premature infants,the dressing can be replaced with aner iodine disinfection and 0-angle tearing method,which can reduce skin damage and phlebitis,and promote the recovery of children.