应用指南建议的方法护理失禁相关性皮炎8例研究报告  

Case series study of incontinence-associated dermatitis for 8 patients with Guidelines recommend measures method

作　　者：蒋琪霞[1] 刘燕平[3] 彭青[1] 韩小琴[2] 

机构地区：[1]南京军区南京总医院门诊部伤口护理中心,210002 [2]南京军区南京总医院门诊部急诊中心,210002 [3]中国康复研究中心北京博爱医院门诊部,100063

出　　处：《中华现代护理杂志》2016年第1期20-23,共4页Chinese Journal of Modern Nursing

基　　金：基金项目：南京军区医药卫生科研基金课题（14MS103）

摘　　要：目的探讨应用指南建议措施方法护理不同程度失禁相关性皮炎的效果，为临床护理提供依据。方法选择2013年1月-2014年12月8例由尿或便失禁引起IAD的患者，评估其失禁原因、类型及严重度后，根据指南建议结合评估结果制定并实施个性化护理方案，持续尿失禁者给予短期留置导尿、持续粪失禁者使用大便失禁护理套装，间断失禁者使用吸湿垫。局部皮肤每日清洗、保护、保湿和润肤一次。每次记录护理时间、费用，直至IAD愈合，记录愈合时间。结果3例中度、5例重度IAD患者全部治愈，平均愈合时间（10．75±3．29）d，护理时间（144．75±92．54）min，护理费用（1532．63±585．52）元。IAD重度患者较中度患者护理时间长、愈合时间长，且费用多，但差异无统计学意义（P〉0．05）。结论应用指南建议均能有效护理失禁相关性皮炎，但应用中需要因人而异采取个性化的护理方法才能取得良好的结果和成本效益。未来需要多中心大样本进一步研究。Objective To study the effects of guideline on directing nursing different severity ofincontinence-association dermatitis （IAD）, and to provide evidence for clinical nursing care. Methods Eight patients with incontinence caused IAD were assessed for the incontinence etiology, classification and severity. The individual nursing protocols were designed and implemented according to guidelines combined with assessment results. The continuous nursing care included maintaining urinary drainage tube for continues urinary incontinence patients, maintaining fecal drainage tube for continues fecal incontinence patients, and absorbent pads for intermittent incontinence patients. Local skin was given daily cleansing, protecting, moisturizing and smoothing. The length of time and costs for each time of nursing were recorded until IAD healed, the healing time were recorded as well. Results Three cases of moderate IAD and five cases of serious IAD were all healed. The average healing time was （ 10.75 ± 3.29） days, the nursing time was （ 144. 75 ±92. 54） minutes and the costs were around （1 532.63 ± 585.52） RMB. Serious IAD patients took more nursing time, healing time and costs than those of moderate IAD patients, but with no significant differences （P 〉 0. 05）. Conclusions The guideline suggestions are effective in treating IAD. However, The individual nursing protocols can gain the better health outcomes and be more cost-effective, which needs more multicenter researches in future.

关 键 词：失禁相关性皮炎 护理 成本效益 循证指南 

分 类 号：R473.75[医药卫生—护理学]