神经外科手术患者眼贴膜面部医用黏胶相关性皮肤损伤影响因素分析

Influencing Factors of Medical Adhesive-related Skin Injury Induced by Eye Mask in Neurosurgery Patients

目的分析神经外科手术患者使用眼贴膜发生医用黏胶相关性皮肤损伤(MARSI)的影响因素,为预防MARSI提供参考。方法收集2019年4-7月于复旦大学附属华山医院行头面部肿瘤和血管常规手术的102例神经外科手术患者的临床资料。统计术后MARSI发生比例,并依据MARSI发生情况分为MARSI组和非MARSI组,应用单因素分析和Logistic多元回归方法分析影响神经外科手术患者发生MARSI的相关因素。结果术后MARSI发生率为17.75%。单因素分析结果提示,MARSI组和非MARSI组患者在年龄、是否合并糖尿病、是否营养不良、是否为过敏体质、面部化妆品皮肤损害史及手术时间方面比较,差异有统计学意义(P<0.05)。Logistic回归分析结果提示,年龄>60岁[OR=1.380,95%CI(1.080~1.763)]、营养不良[OR=1.560,95%CI(1.020~2.388)]、过敏体质[OR=1.958,95%CI(1.169~3.279)]及手术时间>8 h[OR=1.343,95%CI(1.033~1.747)]是影响使用眼贴膜的神经外科手术患者发生MARSI的独立危险因素(P<0.05)。结论神经外科手术患者年龄>60岁、营养不良、过敏体质和手术时间>8 h是影响其使用眼贴膜发生MARSI的独立危险因素,临床需筛查此类患者并制定相关预防措施,以避免MARSI的发生。

Objective To analyze the influencing factors of medical adhesive-related skin injury(MARSI)induced by eye mask in neurosurgery patients,so as to provide reference for the prevention of MARSI.Methods The clinical data of 102 neurosurgery patients who underwent craniofacial tumors or vascular routine surgery in Huashan Hospital Affiliated to Fudan University from April to July 2019 were collected.The proportion of patients with postoperative MARSI was calculated.Patients were divided into MARSI group and non-MARSI group according to occurrence or absence of MARSI.The influencing factors of MARSI in neurosurgery patients were analyzed by univariate analysis and Logistic multivariate regression analysis.Results The incidence of postoperative MARSI was 17.75%.The results of univariate analysis indicated that there were significant differences in age,diabetes,malnutrition,allergic physique,history of skin damage induced by facial cosmetics,and duration of operation between MARSI group and non-MARSI group(P<0.05).The results of Logistic regression analysis showed that age older than 60 years old[OR=1.380,95%CI(1.080~1.763)],malnutrition[OR=1.560,95%CI(1.020~2.388)],allergic physique[OR=1.958,95%CI(1.169~3.279)],and duration of operation longer than 8 h[OR=1.343,95%CI(1.033~1.747)]were independent risk factors of MARSI in neurosurgery patients using eye mask(P<0.05).Conclusion Age older than 60 years old,malnutrition,allergic physique,and duration of operation longer than 8 h are independent risk factors of MARSI in neurosurgery patients using eye mask.It is necessary to screen such patients clinically and formulate relevant preventive measures to avoid the occurrence of MARSI.