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机构地区:[1]复旦大学附属上海市第五医院,上海200032
出 处:《护士进修杂志》2015年第18期1635-1640,共6页Journal of Nurses Training
基 金:复旦大学上海市第五人民医院基金课题;课题号:2013WTHL03
摘 要:目的系统评价不同类型、材质的粪便容量装置对肛周皮肤损伤发生率的影响。方法通过计算机系统检索Cochrane图书馆、Hinghwire Press图书馆、PubMed、Web of Science、中国生物医学文献数据库(CBM)等中外文数据库。检索出所有有关讨论粪便容量装置对肛周皮肤损伤发生率影响的RCT、类实验性研究。筛选出符合纳入标准的研究,由2名研究员对文献质量进行严格的评价、筛选和提取,参考JBI加拿大循证卫生中心的文献评价标准,对符合合并标准的文献数据使用RevMan 5.0软件进行分析及描述。结果研究共纳入13篇文献,其中RCT实验12篇,类实验性研究1篇,共1 219名患者。Meta分析结果提示:使用内置棉条发生肛周皮肤破损率较常规护理组低,合并效应差异有统计学意义[OR=0.15,95%CI(0.08,0.30)],使用肛门造口袋肛周皮肤破损发生率较常规护理组低,合并效应差异有统计学意义[OR=0.05,95%CI(0.03,0.08)],肛门造口袋护理所需时间较常规护理所花时间少,差异有统计学意义[SMD=-2.19,95%CI(-1.38,-0.97)],使用肛门造口袋肛周皮肤破损发生率小于气管导管,差异有统计学意义[OR=0.16,95%CI(0.08,0.34)]。结论内置棉条与肛门造口袋较常规护理在减少肛周皮肤破损方面占有优势,肛周造口袋则较气管导管引流更能保持皮肤的完整性。Objective To evaluate the influence of types, materials of feces containment device on the incidence of anal skin injure. Method The relevant randomized controlled trials, quasi-randomized controlled trials were searched in the Cochrane library, Hinghwire Press library and the databases of PubMed, Web of Science, and CBM and so on. The studies were selected according to the inclusion and exclusion criteria by two researcher, and the quality of included studies was evaluated according to JBI Literature evaluation standard of evidence based health center in Canada. Meta-analysis was conducted by RevMan 5.0. Result The study included 13 papers which RCT experiment 12, experimental study of 1 papers, a total of 1219 patients. The results of Meta-analysis, the use of the built-in cotton occurrence of perianal skin damage rate than the routine nursing group is low, the merger effect was statistically significant in [OR=0. 15, 95%CI(0. 08,0. 30)]. The use of anal colostomy bag perianal skin damage incidence than the conventional nursing group is low, the merger effect with statistical significance of [OR = 0.05, 95% CI (0.03, 0.08)'. The anal ostomy bags nursing time required compared with conventional nursing spend less time, combined with statistical significance [SMD= -2.19, 95 %CI(- 1.38, -0.97)], The use ostomy bag anus week skin damage incidence of less than a tracheal catheter, combined with statistical significance of [OR = 0.16, 95 % CI(0. 08, 0.34)]Conclusion The built-in cotton and anal ostomy bag than routine nursing has an advantage in reducing the perianal skin damage, the integrity of the perianal ostomy bag is tracheal catheter drainage and built-in tampon can maintain the skin.
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