肝移植监护室患儿尿布性皮炎标准化防治流程的制订及应用  

Development and effects evaluation of a standardized procedure of prevention and treatment of diaper dermatitis in infants after liver transplantation in ICU

作　　者：卢芳燕 贾雪征 戴燕红[1] 王燕[1] 汤洒潇[1] 王华芬 LU Fang-yan;JIA Xue-zheng;DAI Yan-hong;WANG Yan;TANG Sa-xiao;WANG Hua-fen

机构地区：[1]浙江大学医学院附属第一医院肝移植中心,杭州市310003 [2]浙江大学医学院附属第一医院护理部,杭州市310003

出　　处：《中华护理教育》2021年第10期925-929,共5页Chinese Journal of Nursing Education

基　　金：浙江省卫生健康科技计划项目(2021KY690)。

摘　　要：目的探讨肝移植监护室患儿实施尿布性皮炎标准化防治流程的临床效果。方法通过系统文献检索、质量评价、证据总结、专家讨论,制订肝移植监护室患儿尿布性皮炎标准化防治流程,主要包括高危因素风险评估、皮炎严重程度评估、分级预防和分度处理、报告机制4个环节。采用非同期对照研究,便利选取某院肝移植中心2020年6月—12月行肝移植手术的患儿为研究对象,按手术时间顺序分组。2020年9月—12月的75例患儿为试验组,应用尿布性皮炎标准化防治流程进行护理;2020年6月—8月的57例患儿为对照组,给予尿布性皮炎常规护理。比较两组患儿尿布性皮炎的发生率、严重程度及愈合天数。结果两组尿布性皮炎发生率比较,差异无统计学意义(χ^(2)=1.235,P=0.266);试验组皮炎严重程度较对照组减轻(Z=2.378,P=0.017);愈合天数较对照组少(Z=2.852,P=0.004),差异均有统计学意义。结论应用尿布性皮炎标准化防治流程能有效改善肝移植监护室患儿尿布性皮炎的护理效果,规范护理人员行为,提高临床护理质量。Objective To explore the effects of a standardized procedure of prevention and treatment of diaper dermatitis in infants after liver transplantation in ICU.Methods Through systematic literature review,quality evaluation,evidence summary,and expert discussion,the standardized procedure of prevention and treatment of diaper dermatitis in infants after liver transplantation in ICU was developed.The procedure included assessment of high risk factors,assessment of dermatitis severity,graded prevention and treatment,and report.A non-synchronous controlled study was conducted.The infants who underwent liver transplantation from June to December 2020 were included.Among them,75 cases were allocated to the experimental group from September to December 2020 and received standardized procedure.Another 57 cases in the control group from June to August 2020 received routine nursing care.We compared the incidence and severity and healing time of diaper dermatitis between the two groups.Results The incidence of diaper dermatitis of two groups were not statistically significant(χ^(2)=1.235,P=0.266).The dermatitis severity was reduced(Z=2.378,P=0.017)and the healing time was significantly shorter than that of the control group(Z=2.852,P=0.004).Conclusion The standardized procedure can effectively improve the effects on pre-vention and treatment of diaper dermatitis,standardize the behavior of nursing staff and improve the quality of care.

关 键 词：重症监护 肝移植 婴幼儿 尿布疹 

分 类 号：R473.72[医药卫生—护理学]