造口周围皮肤潮湿性损伤发生的危险因素分析及护理对策  

Risk factors analysis and nursing countermeasures of skin moist injury around stoma

作　　者：朱倩 林媛珍[1] 顾云雨 胡庆霞[1] ZHU Qian;LIN Yuanzhen;GU Yunyu;HU Qingxia(The Second Affiliated Hospital of Nanchang University,Jiangxi 330000 China)

机构地区：[1]南昌大学第二附属医院,330000

出　　处：《全科护理》2022年第9期1254-1257,共4页Chinese General Practice Nursing

基　　金：江西省卫生健康委科技计划项目,编号:20201055。

摘　　要：目的:探讨造口周围皮肤潮湿性损伤的相关危险因素及其干预措施。方法:回顾性分析2019年10月—2021年9月在南昌大学第二附属医院泌尿外科、胃肠外科行造口术治疗的95例病人的临床资料,采用单因素分析与多因素分析探讨造口周围皮肤潮湿性损伤发生的相关危险因素。结果:造口周围皮肤潮湿性损伤发生率为42.11%(40/95);单因素分析结果显示,造口部位、底盘渗漏次数、排泄物种类及性状、底盘区域手术伤口、文化程度与造口周围皮肤潮湿性损伤发生有关(P<0.05);多因素分析结果显示,回肠造口[OR=4.804,95%CI(1.817,12.702),P=0.002]、尿路造口[OR=12.963,95%CI(2.940,57.154),P=0.001]、底盘渗漏次数>3次[OR=3.793,95%CI(1.199,12.002),P=0.023]、排泄物性状为水样便[OR=16.800,95%CI(3.639,77.553),P<0.001]、排泄物为尿液[OR=56.000,95%CI(6.779,462.639),P<0.001]、有底盘区域手术伤口[OR=3.702,95%CI(1.050,13.044),P=0.042]、文化程度初中及以下[OR=2.932,95%CI(1.200,7.161),P=0.018]是造口周围皮肤潮湿性损伤发生的高危因素。结论:造口周围皮肤潮湿性损伤发生与造口部位、底盘渗漏次数、排泄物种类及性状、底盘区域手术伤口、文化程度有关。护理人员应针对相关危险因素制订相应的预防措施,减少病人造口周围皮肤潮湿性损伤发生。Objective:To explore the related risk factors and intervention measures of skin moist injury around the stoma.Methods:The clinical data of 95 patients who underwent ostomy in the Department of Urology and Gastrointestinal Surgery of the Second Affiliated Hospital of Nanchang University from October 2019 to September 2021 were retrospectively analyzed.Univariate analysis and multivariate analysis were used to investigate the risk factors of skin moist injury around stoma.Results:The incidence of skin moist injury around the stoma was 42.11%(40/95).The results of univariate analysis showed that the site of stoma, the number of leakage in the chassis, the type and character of excreta, the surgical wound in the chassis area, and the level of education were related to the occurrence of moist skin injury around the stoma(P<0.05).Multivariate analysis showed that, ileostomy[OR=4.804,95%CI(1.817,12.702),P=0.002],urostomy[OR=12.963,95%CI(2.940,57.154),P=0.001],and the number of chassis leakage >3 times [OR=3.793,95%CI(1.199,12.002),P=0.023],excreta was watery stool [OR=16.800,95%CI(3.639,77.553),P<0.001],excreta was urine [OR=56.000,95%CI(6.779,462.639),P<0.001],and there were surgical wounds in the chassis area [OR=3.702,95%CI(1.050,13.044),P=0.042] and junior high school education [OR=2.932,95%CI(1.200,7.161),P=0.018] were high risk factors for the occurrence of skin moist injury around the stoma.Conclusion:The occurrence of moist skin injury around stoma was related to stoma site, number of chassis leakage, type and character of excreta, surgical wound in chassis area and education level.Nursing staff should formulate corresponding preventive measures for related risk factors to reduce the occurrence of moist skin injury around the stoma.

关 键 词：肠造口 皮肤破损 回肠造口 危险因素 护理对策 

分 类 号：R473.6[医药卫生—护理学]