电极片不同更换时间对新生儿皮肤损伤和心电监测效果影响的研究

Influence of different times to change disposable electrocardiogram monitoring electrodes on neonatal skin injury and monitoring effect

目的观察一次性心电监护电极片不同更换时间对新生儿皮肤损伤及监测效果的影响,为探索新生儿最佳电极片更换时间提供参考依据。方法选取2019年9月至2020年4月入住本院新生儿重症监护病房并持续使用心电监护的危重患儿96例,将其分为试验组和对照组,各48例。试验组患儿中,男性25例,女性23例,每2天更换电极片;对照组患儿中,男性28例,女性20例,每天更换电极片。观察两组患儿电极片粘贴部位各类皮肤损伤症状发生情况及电极片脱落、粘胶遗留、心电图波形状况。结果试验组共更换电极片163次,观察到红斑共88次(53.99%),丘疹13次(7.98%),表皮撕脱9次(5.52%),水泡2次(1.23%)。对照组共更换电极片382次,观察到红斑184次(48.17%),丘疹42次(10.99%),表皮撕脱39次(10.21%),水泡10次(2.62%)。其中丘疹、表皮撕脱、水泡发生情况比较差异均有统计学意义(均 P<0.05),红斑发生情况差异无统计学意义(P>0.05)。 电极片脱落、粘胶遗留以及心电图波形比较,差异均无统计学意义(均 P>0.05)。结论 每 2天更换 1次电极片可减少皮肤损伤,不会增加电极片的脱落及粘胶遗留,不影响心电监测效果,具有较好的 成本效益。

Objective To observe the influence of different times to change disposable electrocardiogram(ECG)monitoring electrodes on neonatal skin injury and monitoring effect,to explore the better replacement time of electrodes for neonates.Methods Ninety-six children treated at the neonatal intensive care unit of our hospital and monitored by ECG continuously from September,2019 to April,2020 were selected,and were divided into an experimental group and a control group,with 48 cases in each group.In the experimental group,25 cases were male,and 23 females;they changed the electrodes every day.In the control group,28 cases were male,and 20 females;they changed the electrodes every day.The incidences of various skin injury on the adhesive sites of the electrodes,electrode falling off,adhesive retention,and ECG waveforms in the two groups were observed.Results In the experimental group,163 times of electrode replacements were performed,88 times of erythema(53.99%),13 times of papules(7.98%),9 times of epidermal avulsion(5.52%),and 2 times of blisters(1.23%)were observed.In the control group,the electrodes were replaced 382 times,and erythema was observed 184 times(48.17%),papules 42 times(10.99%),epidermal avulsion 39 times(10.21%),and blisters 10 times(2.62%).There was statistical significance in the occurrence of papules,epidermal avulsion,and blisters(all P<0.05),while there was no statistical significance in the occurrence of erythema(P>0.05).There were no statistically significant differences in electrode removal,adhesive residue,and ECG waveform(all P>0.05).Conclusion Replacing the electrodes every other day can reduce the skin damage,does not increase the electrode falling off and adhesive retention,and does not affect the ECG monitoring effect,so it has better cost effectiveness.