二、三级防护装备所致医护人员潮湿相关性皮肤损伤的现况分析及对策

Analysis and countermeasures of current situation of moist-associated skin damage of medical staff caused by the second and third levels of personal protection equipment

目的分析二、三级防护装备所致的医护人员潮湿相关性皮肤损伤发生特征、相关因素和预防现况,为制订防治对策提供依据。方法2020年2月8—22日,采用便利抽样法,选取全国161家医院的1814名医护人员为研究对象。设计问卷上传问卷星网站,将问卷链接发送至医护人员的微信工作群,医护人员自愿采用手机在线填写和提交人口学资料、潮湿相关性皮肤损伤资料和预防措施资料等。从网站导出数据,双人核对后建立数据库。采用SPSS软件分析其潮湿相关性皮肤损伤的发生特征、相关因素、预防现况,并提出对策。结果1761名来自全国161家医院的医护人员提交了问卷,其中男性290名(16.47%),女性1471名(83.53%)。潮湿相关性皮炎现患率为18.85%(332/1761),其中三级防护装备现患率高于二级装备,差异有统计学意义(P=0.001)。穿戴时间>4 h组的发生率高于≤4 h组,差异有统计学意义(P<0.05)。多部位现患率高于单部位(P<0.001)。二项Logistic回归分析显示,主要的关联因素中呈现增加风险的有出汗潮湿(OR=168.52,P<0.001)、佩戴三级防护装备(OR=1.65,P<0.05),损伤前采取预防措施仅占12.72%(224/1761)。结论二、三级防护装备所致的医护人员潮湿相关性皮肤损伤发生率较高,其中出汗潮湿和三级装备是主要风险因素,预防不足。需要加强评估、洁肤、润肤、护肤、吸湿等预防策略,损伤后需在预防基础上做好局部抗炎和保护处理。

Objective To analyze characteristics,related factors and prevention status of moist-associated skin damage of medical staff caused by the second and third levels of personal protection equipment,and provide basis for formulating prevention and treatment countermeasures.Methods From February 8 to 22,2020,the convenient sampling method was adopted to select 1814 medical staff from 161 hospitals in China as the research objects.The questionnaire was uploaded to Questionnaire Star website,and the questionnaire link was sent to the WeChat working group of medical staff.Medical staff voluntarily used mobile phones to fill in and submit demographic data,moist-associated skin damage data,preventive measures data and other data online.Data were exported from the website and the database was established after double check.SPSS software was used to analyze the occurrence characteristics,related factors and prevention status of moist-associated skin damage and put forward countermeasures.Results A total of 1761 medical staff from 161 hospitals in China submitted the questionnaire,including 290 males(16.47%)and 1471 females(83.53%).The overall prevalence rate of moisture-related skin damage was 18.85%(332/1761).The prevalence rate of third-level personal protective equipment was higher than that of second-level personal protective equipment,and the difference was statistically significant(P=0.001).The incidence of wearing time greater than 4 hours group was higher than that of less than or equal to 4 hours group,and the difference was statistically significant(P<0.05).The prevalence rate of multiple sites was higher than that of single site(P<0.001).Binary Logistic regression analysis showed that the main associated factors that increased the risk were sweating and dampness(OR=168.52,P<0.001)and wearing third-level personal protective equipment(OR=1.65,P<0.05),and only 12.72%(224/1761)of them took preventive measures before damage.Conclusions The incidence of moist-associated skin damage of medical staff caused by the second and third levels of personal protective equipment is relatively high.Among them,sweating and wetness and the third level equipment are the main risk factors,and the prevention is insufficient.It is necessary to strengthen assessment,cleansing,moisturizing,skin care,moisture absorption and other preventive strategies.After damage,local anti-inflammatory and protective treatments should be done on the basis of prevention.