ICU患者中心静脉导管置入部位医用粘胶相关性皮肤损伤发生的影响因素分析

Influencing factors of medical adhesive-related skin injury at the site of central venous catheterplacement in ICU patients

目的探讨ICU患者中心静脉导管(CVC)置入部位医用粘胶相关性皮肤损伤(MARSI)发生的影响因素。方法采用便利抽样法,选取2019年1—11月北京市某三级甲等医院普外科ICU和血管外科ICU收治的479例患者为研究对象,采用自行设计的资料收集表进行调查。采用二项Logistic回归分析ICU患者CVC置入部位发生MARSI的影响因素。结果ICU患者CVC置入部位的MARSI发生率为6.89%(33/479)。二项Logistic回归分析结果显示,年龄、入住ICU时长、NRS 2002评分、皮肤水肿是ICU患者CVC置入部位发生MARSI的危险因素(OR值分别为1.033、1.005、4.221、13.107;P<0.05),血清白蛋白、皮肤黏膜颜色正常是ICU患者CVC置入部位发生MARSI的保护因素(OR值分别为0.876、0.052;P<0.01)。结论护士应加强对具有发生MARSI危险因素的ICU患者的评估与干预,有效预防CVC置入部位MARSI的发生。

Objective To explore the influencing factors of medical adhesive-related skin injury(MARSI)at the site of central venous catheter(CVC)placement in ICU patients.Methods Using the convenient sampling method,a total of 479 patients who were admitted to General Surgery ICU and Vascular Surgery ICU of a ClassⅢGrade A hospital in Beijing were selected as the research objects from January to November 2019.A self-designed data collection form was used for investigation.Binomial Logistic regression was used to analyze the influencing factors of MARSI at the CVC placement site in ICU patients.Results The incidence of MARSI at the CVC placement site in ICU patients was 6.89%(33/479).Binary logistic regression analysis showed that age,length of stay in ICU,NRS 2002 score and skin edema were risk factors for MARSI at the CVC placement site in ICU patients(OR=1.033,1.005,4.221,13.107;P<0.05).Serum albumin and normal skin color were protective factors for MARSI at the CVC placement site in ICU patients(OR=0.876,0.052;P<0.01).Conclusions Nurses should strengthen the evaluation and intervention of ICU patients with risk factors for MARSI to effectively prevent the occurrence of MARSI at the CVC placement site.