液体敷料联合透明敷料在防治成人重症患者失禁相关性皮炎中的效果观察

Effect of liquid dressing combined with transparent dressing in prevention and treatment of incontinence-associated dermatitis in severe adult patients

目的探讨液体敷料联合透明敷料在防治成人重症患者失禁相关性皮炎(IAD)中的应用效果。方法本研究为试验研究, 选择2020年1月至2021年12月在南通大学附属南京江北医院重症医学科住院的成人重症患者150例, 采用随机数字法分为试验组(75例)与对照组(75例), 对照组男39例、女36例, 年龄(68.32±17.23)岁, 急性生理学和慢性健康状况评价(APACHE)Ⅱ评分(24.68±7.12)分;试验组男43例、女32例, 年龄(69.04±16.39)岁, APACHE II评分(23.73±6.34)分。对照组皮肤清洁后应用液体敷料, 试验组在此基础上应用透明敷料, 比较两组患者IAD治愈率、压力性损伤发生率、会阴皮肤评分、愈合时间和皮炎治疗费用。计量资料采用t检验, 计数资料采用卡方检验。结果试验组IAD治愈率为98.67%(74/75), 护理后会阴皮肤评分(4.55±1.35)分, 皮炎愈合时间(4.69±1.95)d, 治疗相关费用(70.19±28.28)元, 对照组IAD治愈率为86.67%(65/75), 护理后会阴皮肤评分(5.12±1.21)分, 皮炎愈合时间(5.78±2.11)d, 治疗相关费用(168.48±68.29)元, 两组比较差异均有统计学意义(均P<0.05)。试验组压力性损伤发生率1.33%(1/75), 对照组压力性损伤发生率5.33%(4/75), 两组比较差异无统计学意义(P>0.05)。结论液体敷料联合透明敷料在防治成人重症患者0~1级IAD效果可靠, 值得临床推广应用。

Objective To investigate the effect of liquid dressing combined with transparent dressing in the prevention and treatment of incontinence associated dermatitis in adult severe patients.Methods This study was an experimental study.One hundred and fifty adult severe patients hospitalized in Department of Critical Care Medicine,Nanjing Jiangbei Hospital from January 2020 to December 2021 were randomly divided into an experimental group and a control group, with 75 cases in each group. In the control group, there 39 males and 36 females, they were (68.32±17.23) years old, and their APACHE Ⅱ score was (24.68±7.12). In the experimental group, there were 43 males and 32 females, they were (69.04±16.39) years old, and their APACHEⅡ score was (23.73±6.34). The control group were treated with liquid dressing after skin cleaning, and the experimental group with liquid dressing and transparent dressing. The cured rates of IAD, the incidences of pressure injury, the scores of perineal skin, the healing times, and the treatment costs were compared between these two groups. t test was used for measurement data, and Chi-square test for count data. Results The cured rate of IAD, perineal skin score after nursing, dermatitis healing time, and treatment related cost were 98.67% (74/75), (4.55±1.35), (4.69±1.95) days, and (70.19±28.28) yuan in the experimental group, and were 86.67% (65/75), (5.12±1.21), (5.78±2.11) d, and (168.48±68.29) yuan in the control group, with statistical differences between the two groups (all P<0.05). The incidence of pressure injury was 1.33% (1/75) in the experimental group, and was 5.33% (4/75) in the control group, with no statistical difference between the two groups (P>0.05). Conclusion The effect of liquid dressing combined with transparent dressing in the prevention and treatment of grade 0-1 IAD in severe adult patients is reliable and worthy of clinical application.