危重症患者失禁性皮炎的现状及影响因素分析

Analysis of the current status and influencing factors of incontinence dermatitis in critically ill patients

目的 调查危重症患者失禁性皮炎的发生状况并分析其影响因素,为制定有针对性的失禁性皮炎预防方案提供参考依据。方法 选取2021年8月-2022年2月衡阳市某三级甲等医院的5个重症监护室收治的184例失禁患者为调查对象。调查患者一般资料、营养情况、失禁情况、皮肤情况等。通过单因素分析筛选及多因素Logistics回归模型分析失禁性皮炎的影响因素。结果 184例失禁患者中,发生失禁性皮炎的有29例,占15.8%。单因素分析显示,住院天数、是否采用肠内营养、血红蛋白值、抗菌药种数、是否在妊娠晚期、Waterlow评分、大便性状与IAD发生相关(P<0.05)。多因素Logistics回归分析结果显示,大便性状、是否在妊娠晚期、使用抗菌药种数、Waterlow评分,是失禁性皮炎发生的影响因素(P<0.05)。结论 危重症患者失禁性皮炎发生率为15.8%。妊娠晚期、使用抗菌药种数多、Waterlow评分高、大便性状不良的失禁患者发生IAD的概率较大。

Objective To investigate the occurrence status of incontinence dermatitis in critically ill patients and analyse the influencing factors,in order to provide a reference basis for the development of targeted incontinence dermatitis prevention programs.Methods 184 incontinence patients admitted to five intensive care units of a Class III Grade A hospital in Hengyang from August 2021 to February 2022 were selected for the survey.General information,nutritional status,incontinence,and skin condition of the patients were investigated.The influencing factors of incontinence dermatitis were analysed by univariate analysis screening and multifactorial Logistics regression model.Results Among 184 incontinent patients,incontinence dermatitis occurred in 29 cases,accounting for 15.8%.Univariate analysis showed that the number of days of hospitalisation,the use of enteral nutrition or not,haemoglobin values,the number of antimicrobial species,whether in late pregnancy,Waterlow score,and stool properties were associated with the occurrence of IAD(P<0.05).The results of multifactorial logistic regression analysis showed that stool trait,whether in late pregnancy,number of antimicrobials used,and Waterlow score,were influential factors in the occurrence of incontinence dermatitis(P<0.05).Conclusion The incidence of incontinence dermatitis in critically ill patients was 15.8%.The probability of IAD was higher in incontinent patients with late pregnancy,high number of antimicrobials used,high Waterlow score,and poor stool characteristics.