腰椎骨折伴脊髓损伤患者失禁相关性皮炎的集束化护理预防体会  

Cluster preventive nursing experience for incontinence-associated dermatitis in patients with lumbar vertebral fracture and spinal cord injury

作　　者：张晓艺[1] 钟小华[1] 张滨[1] 孙士玉 孙慧琳[2] ZHANG Xiao-yi;ZHONG Xiao-hua;ZHANG Bin;SUN Shi-yu;SUN Hui-lin(Department of Rehabilitation,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,Guangdong,China;不详)

机构地区：[1]广东药科大学附属第一医院康复科,广东广州510080 [2]广东药科大学附属第一医院内分泌科,广东广州510080

出　　处：《广东医学》2020年第18期1900-1903,共4页Guangdong Medical Journal

摘　　要：目的探讨集束化护理对腰椎骨折伴脊柱损伤患者失禁相关性皮炎(incontinence-associated dermatitis,IAD)的预防效果,总结其护理体会。方法将106例腰椎骨折伴脊髓损伤患者按随机抽签分为对照组(n=53)与观察组(n=53),对照组行常规预防护理,观察组采用集束化护理,比较两组患者会阴评估工具(PAT)、肛周皮肤评估表(PSAT)及IAD严重程度评估表(IADS)评分,统计两组IAD发生率、发生时间,观察两组发病部位持续潮湿、细菌定植、合并压疮及失禁频次状况。结果护理前,两组PAT评分比较差异无统计学意义(P>0.05),护理2周,观察组PAT、IADS评分、IAD发生率及IAD严重程度分级均显著低于对照组,且观察组IAD发生时间明显晚于对照组(P<0.05);观察组发病部位持续潮湿、细菌定植及合并压疮所占比例均低于对照组(P<0.05);两组失禁频次比较虽差异无统计学意义(P>0.05),但观察组PAST表皮肤颜色、完整性、浸渍面积及主诉症状等维度评分均低于对照组(P<0.05)。结论集束化预防护理可降低腰椎骨折伴脊髓损伤患者IAD发生风险,减轻患者皮损程度,改善患者发病部位皮肤状况。Objective To analyze the value of cluster preventive nursing in preventing incontinence-associated dermatitis(IAD)in patients with lumbar vertebral fracture and spine cord injury.Methods One hundred and sixty patients with lumbar vertebral fractures and spinal cord injuries were randomly divided into the control group and the observation group(n=53).The control group received routine nursing for incontinence while the observation group received cluster preventive nursing.The Perineum Assessment Tool(PAT),Perianal Skin Assessment Tool(PSAT)and IAD Severity Instrument(IADS)were used to assess the risk of IAD,condition of perianal skin and severity of IAD.The incidence and onset time of IAD in both groups were statistically analyzed.The persistent dampness at pathogenic sites,bacterial colonization,pressure ulcers and incontinence frequency in both groups were observed.Results There was no significant difference in PAT score between the two groups before nursing(P>0.05).The PAT score of the observation group was significantly lower than that of the control group,while the IADS score was significantly lower than that of the control group after 2 weeks of nursing(P≤0.05).The incidence of IAD in observation group was significantly lower than that in the control group.The severity of IAD was significantly lower than that in the control group,and the onset time of IAD was significantly later than that in the control group(P≤0.05).The incidences of persistent dampness at pathogenic sites,bacterial colonization and pressure sores in the observation group were significantly lower than those in the control group(P≤0.05).There was no significant difference in the incontinence frequency between the two groups(P>0.05),but the scores of skin color,integrity,dipping area and self-reported symptoms in the observation group were significantly lower than those in the control group(P≤0.05).Conclusion Cluster preventive nursing can reduce the risk of IAD in patients with lumbar vertebral fractures and spinal cord injuries,reli

关 键 词：腰椎骨折 脊髓损伤 失禁相关性皮炎 集束化护理 

分 类 号：R683.2[医药卫生—骨科学] R694.54[医药卫生—外科学]