感染性胰腺坏死组织清创术后患者皮肤管理的效果分析  

Analysis of skin management effect in patients with infectious pancreatic necrosis after debridement

作　　者：杨洋[1] 靳瑾 羡红涛[1] 郭京[1] 王欣然[1] Yang Yang;Jin Jin;Xian Hongtao;Guo Jing;Wang Xinran(Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;School of Nursing,Capital Medical University,Beijing 100049,China)

机构地区：[1]首都医科大学宣武医院普外科,北京100053 [2]首都医科大学护理学院,北京100049

出　　处：《中国实用护理杂志》2020年第33期2590-2595,共6页Chinese Journal of Practical Nursing

基　　金：首都护理学研究专项项目(17HL12)。

摘　　要：目的探讨感染性胰腺坏死组织清创术后引流管周围刺激性皮炎护理效果。方法选取2018年3月至2019年3月收治在首都医科大学宣武医院行感染性胰腺坏死组织清创术后引流患者108例,按照入院时间分为试验组54例和对照组54例,对照组给予常规护理,试验组给予阶梯式皮肤护理,包括教育培训、评估、皮肤准备、皮肤保护剂以及一次性泌尿造口袋的使用等内容,并进行效果评价。结果试验组刺激性皮炎的发生率为20.4%(22/54),对照组40.7%(11/54),2组比较差异有统计学意义(χ^2值为5.280,P<0.05);试验组治愈4例占36.36%,Ⅰ级5例占45.45%,Ⅱ级2例占18.18%,Ⅲ级0,对照组分别为0,13例占59.09%,8例占36.36%,1例占4.54%,2组严重程度比较差异有统计学意义(χ^2值为8.353,P<0.05);试验组住院期间皮炎的发生时间和总护理时长分别为(18.00±2.25)d、(12.69±1.96)h,对照组分别为(12.13±5.84)d、(15.29±2.09)h,2组比较差异具有统计学意义(t值为29.167、-2.791,均P<0.05);试验组总护理费用(570.38±88.01)元,对照组(448.79±59.44)元,2组比较差异无统计学意义(t值为-0.372,P>0.05)。结论阶梯式皮肤护理方案降低了感染性胰腺坏死组织清创术后引流患者刺激性皮炎的发生率、严重程度,延长了刺激性皮炎的发生时间,提高了护理人员的工作效率。Objective To investigate the nursing effect of irritant dermatitis around drains after debridement of infected pancreatic necrotic tissue.Methods A total of 108 patients with post-infectious pancreatic necrosis tissue debridement drains were divided into the experimental group and the control group with 54 patients in each group according to the time of hospital admission.The control group was given routine care and the experimental group was given stepped skin care,including education and training,assessment,skin preparation,and skin protectants and the use of disposable urinary ostomy bags,and the effect was evaluated.Results The incidence of irritant dermatitis was 20.4%(22/54)in the test group and 40.7%(11/54)in the control group,with a statistically significant difference between the 2 groups(χ^2 value was 5.280,P<0.05);4 cases(36.36%)were cured in the experimental group,5 cases(45.45%)in class I,2 cases(18.18%)in classⅡ,0 cases in classⅢ,and 0,13 cases(59.09%),8 cases(36.36%),1 case(4.54%)in the control group,respectively.The difference between the two groups was statistically significant(χ^2 value was 8.353,P<0.05);In the experimental group,the duration of dermatitis incidence and total nursing time during hospitalization were(18.00±2.25)d and(12.69±1.96)h,respectively,compared with(12.13±5.84)d and(15.79±2.09)h in the control group,which were statistically significant between the two groups(t value was 29.167,-2.791,all P<0.05);the total cost of care in the experimental group was(570.38±88.01)yuan and(448.79±59.44)yuan in the control group,the difference between the two groups was not statistically significant(t value was-0.372,P>0.05).Conclusion The stepped skin care protocol can reduce the incidence of infected pancreatic necrosis after tissue debridement and improve caregivers′work efficiency.

关 键 词：刺激性皮炎 感染性胰腺坏死组织清创术 护理 

分 类 号：R473.6[医药卫生—护理学]