贝复新联合肛门袋负压引流冲洗装置在ICU失禁相关性皮炎患者中的应用

doi:10.3760/cma.j.issn.1007-1245.2023.21.023

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (21): 3094-3098.DOI: 10.3760/cma.j.issn.1007-1245.2023.21.023

贝复新联合肛门袋负压引流冲洗装置在ICU失禁相关性皮炎患者中的应用

林玲玲¹ 蔡莹莹¹ 罗斌² 谢丹玲² 黄琼珊³

¹揭阳市人民医院胸心外科二科，揭阳　522000；²揭阳市人民医院重症医学科，揭阳　522000；³揭阳市人民医院护理部，揭阳　522000

收稿日期:2023-07-20 出版日期:2023-11-01 发布日期:2023-11-22
通讯作者: 蔡莹莹，Email：871385306@qq.com
基金资助:
揭阳市医学科学技术研究项目（揭市卫〔2021〕57号222号）

Application of bovine basic fibroblast growth factor gel combined with anal bag negative pressure drainage and flushing device in nursing care for ICU patients with incontinence-associated dermatitis

Lin Lingling¹, Cai Yingying¹, Luo Bin², Xie Danling², Huang Qiongshan³

¹Department of 2nd Cardiothoracic Surgery, Jieyang People's Hospital, Jieyang 522000, China; ²Intensive Care Unit, Jieyang People's Hospital, Jieyang 522000, China; ³Department of Nursing, Jieyang People's Hospital, Jieyang 522000, China

Received:2023-07-20 Online:2023-11-01 Published:2023-11-22
Contact: Cai Yingying, Email: 871385306@qq.com
Supported by:
Jieyang Medical Science and Technology Research Program (〔2021〕57-222)

摘要/Abstract

摘要：

目的　探讨贝复新联合肛门袋负压引流冲洗装置在重症监护室（ICU）失禁相关性皮炎（IAD）患者护理中的应用效果。方法　本研究为随机对照试验。选取2021年7月至2023年3月在揭阳市人民医院ICU住院的60例IAD患者作为研究对象，采用随机数字表法将研究对象分为对照组和观察组，各30例。研究过程中3例患者退出本研究，最终对照组纳入28例，观察组纳入29例。对照组男18例，女10例，年龄（62.43±13.63）岁，在常规操作基础上应用肛门袋负压引流冲洗装置；观察组男16例，女13例，年龄（63.62±14.11）岁，在常规操作基础上联合应用贝复新和肛门袋负压引流冲洗装置。对比两组患者IAD严重程度、中文版IAD严重程度分级评估工具（Incontinence-Associated Dermatitis and Its Severity Instrument，IADS）减分率、IAD愈合时间。采用t检验、非参数检验、χ²检验。结果　干预前两组患者IAD严重程度差异无统计学意义（Z=-0.154，P=0.878）。干预后第3天和第6天，对照组患者IAD严重程度分别降低至2.0（3.0）分、0（0）分，观察组降低至3.0（2.0）分、0（3.0）分，差异均有统计学意义（均P<0.05）；对照组患者IADS减分率分别为33.33%（19.92%）、100.00%（42.71%），观察组分别为57.14%（63.33%）、100.00%（0），差异均有统计学意义（均P<0.05）。对照组IAD愈合时间为（8.04±4.97）d，观察组为（6.10±3.89）d，差异无统计学意义（t=1.638，P=0.107）。结论　ICU IAD患者应用贝复新联合肛门袋负压引流冲洗装置，能有效缓解IAD严重程度，促进IAD愈合，值得临床推广应用。

关键词:

失禁相关性皮炎, 贝复新, 肛门袋负压引流冲洗装置

Abstract:

Objective　To explore the application effect of bovine basic fibroblast growth factor gel combined with anal bag negative pressure drainage and flushing device in nursing care for patients with incontinence-associated dermatitis (IAD) in intensive care unit (ICU). Methods　This study was a randomized controlled trial. A total of 60 IAD patients were selected as research subjects from July 2021 to March 2023 in the ICU of Jieyang People's Hospital. The subjects were divided into a control group (30 cases) and an observation group (30 cases) by the random number table method. In the course of the study, 3 patients withdrew from the study. Finally, 28 cases were included in the control group and 29 cases in the observation group. In the control group, there were 18 males and 10 females, aged (62.43±13.63) years; in the observation group, there were 16 males and 13 females, aged (63.62±14.11) years. The control group was treated with anal bag negative pressure drainage and flushing device on the basis of routine operation, and the observation group was treated with bovine basic fibroblast growth factor gel and anal bag negative pressure drainage and flushing device on the basis of routine operation. The severity of IAD, the reduction rate of the Chinese version of the Incontinence-Associated Dermatitis and Its Severity Instrument (IADS), and the IAD healing time were compared between the two groups. t test, non-parametric test, and χ² test were used. Results　There was no statistically significant difference in the severity of IAD between the two groups before intervention (Z=-0.154, P=0.878). On the 3rd and 6th day after intervention, the severity of IAD in the control group decreased to 2.0 (3.0) and 0 (0) points, respectively, while that in the observation group decreased to 3.0 (2.0) and 0 (3.0) points, respectively, with statistically significant differences (both P<0.05); the reduction rates of IADS in the control group were 33.33% (19.92%) and 100.00% (42.71%), respectively, and those in the observation group were 57.14% (63.33%) and 100.00% (0), respectively, with statistically significant differences (both P<0.05). The healing time of IAD was (8.04±4.97) days in the control group and (6.10±3.89) days in the observation group, without statistically significant difference between the two groups (t=1.638, P=0.107). Conclusion　The application of bovine basic fibroblast growth factor gel combined with anal bag negative pressure drainage and flushing device in ICU IAD patients can effectively alleviate the severity of IAD and promote the healing of IAD, worthy of clinical promotion.

Key words:

Incontinence-associated dermatitis, Bovine basic fibroblast growth factor gel, Anal bag negative pressure drainage and flushing device

林玲玲蔡莹莹罗斌谢丹玲黄琼珊.

贝复新联合肛门袋负压引流冲洗装置在ICU失禁相关性皮炎患者中的应用 [J]. 国际医药卫生导报, 2023, 29(21): 3094-3098.

Lin Lingling, Cai Yingying, Luo Bin, Xie Danling, Huang Qiongshan.

Application of bovine basic fibroblast growth factor gel combined with anal bag negative pressure drainage and flushing device in nursing care for ICU patients with incontinence-associated dermatitis [J]. International Medicine and Health Guidance News, 2023, 29(21): 3094-3098.

参考文献

[1] Bayón García C, Binks R, De Luca E, et al. Prevalence, management and clinical challenges associated with acute faecal incontinence in the ICU and critical care settings: the FIRST cross-sectional descriptive survey[J]. Intensive Crit Care Nurs, 2012,28(4):242-250. DOI: 10.1016/j.iccn.2012.01.005.
[2] Kottner J, Kolbig N, Bültemann A, et al. Incontinence associated dermatitis: a position paper[J]. Hautarzt, 2020,71(1):46-52. DOI: https://doi.org/10.1007/s00105-019- 04480-7.
[3] Gray M, Giuliano KK. Incontinence-associated dermatitis and immobility as pressure injury risk factors: a multisite epidemiologic analysis[J]. J Wound Ostomy Continence Nurs, 2017,45(1):63-67. DOI: 10.1097/WON.0000000000000390.
[4] 张煜,刘均娥,高凤莉,等. 基于行动研究的ICU失禁性皮炎护理方案改进与实施[J]. 护理学杂志,2019,34(23):36-40. DOI: 10.3870/j.issn.1001-4152.2019.23.036.
[5] Hillery S. Caring for patients with urinary incontinence-associated dermatitis[J]. Br J Nurs,2019,28(9): S26-S28. DOI: 10.12968/bjon.2019.28.9.S26.
[6] 张宇,张晓雪,赵晓维,等. 危重症患者失禁性皮炎的发生现况及其影响因素[J]. 解放军护理杂志,2018,35(16): 16-21,26. DOI: 10.3969/j.issn.1008-9993.2018.16.003.
[7] Campbell J, Cook JL, Doubrovsky A, et al. Exploring incontinence-associated dermatitis in a single center intensive care unit: a longitudinal point prevalence survey[J]. J Wound Ostomy Cont, 2019, 46(5): 401-407. DOI: 10.1097/WON.0000000000000571.
[8] 陈亚敏. 不同皮肤保护剂防治失禁性皮炎的循证研究[D]. 兰州:兰州大学,2023. DOI: 10.27204/d.cnki.glzhu.2022. 001584.
[9] 白敏,李娜. 不同皮肤保护剂对失禁性皮炎预防和治疗效果的网状Meta分析[J]. 军事护理, 2022, 39(10): 79-83. DOI: 10.3969/j.issn.2097-1826.2022.10.021.
[10] 谢建仪,吁英,黎海阳. 腹部联合肛周穴位按摩预防重症脑卒中大便失禁患者失禁性皮炎的效果观察[J]. 护理学报,2017,24(19):55-58. DOI: 10.16460/j.issn1008-9969. 2017.19.055.
[11] 魏燕. 重症老年大便失禁致相关性皮炎危险因素及改良肛门造口袋干预效果[J]. 包头医学,2019,43(3):53-55. DOI: 10.3969/j.issn.1007-3507.2019.03.024.
[12] 雷伶俐,文燕舞,徐雪平,等. 一件式造口袋用于大便失禁患者保护肛周皮肤的效果观察[J]. 护理学报,2010,17(10):39-39. DOI: 10.3969/j.issn.1008-9969.2010.10.016.
[13] 孙红霞,刘新平,商庆竹,等. 液体敷料联合透明敷料在防治成人重症患者失禁相关性皮炎中的效果观察[J]. 国际医药卫生导报,2022,28(17):2492-2495. DOI: 10.3760/cma.j.issn.1007-1245.2022.17.028.
[14] Zbinden A, Browne S, Altiok EI, et al. Multivalent conjugates of basic fibroblast growth factor enhance in vitro proliferation and migration of endothelial cells[J]. Biomater Sci, 2018, 6(5): 1076-1083. DOI: 10.1039/c7bm01052d.
[15] Chen G, Ren J, Deng Y, et al. An injectable, wound-adapting, self-healing hydrogel for fibroblast growth factor 2 delivery system in tissue repair applications[J]. J Biomed Nanotechnol, 2017, 13(12): 1660-1672. DOI: 10.1166/jbn.2017.2443.
[16] 方慧. 贝复新凝胶与尤卓尔乳膏联合治疗儿童湿疹的疗效观察[D]. 芜湖:皖南医学院,2022. DOI: 10.27374/d.cnki.gwnyy.2021.000135.
[17] 李文俊. 贝复新和易孚对促进头颈部手术切口愈合的比较研究[D]. 大连:大连医科大学,2021. DOI: 10.26994/d.cnki.gdlyu.2020.000117.
[18] 杨洁. 贝复新联合酸化水用于2、3期压疮的疗效评价[J]. 医学理论与实践,2019,32(20): 3359-3361. DOI: 10.19381/j.issn.1001-7585.2019.20.077.
[19] Beeckman D. Proceedings of the global IAD expert panel. Incontinence-associated dermatitis: moving prevention forward [EB/OL]. (2015-2-13) [2023-7-11]. http://www.Wounds international.com.
[20] 中国医师协会皮肤科医师分会皮肤美容事业发展工作委员会. 中国皮肤清洁指南[J]. 中华皮肤科杂志,2016,49(8):537-540. DOI: 10.3760/cma.j.issn.0412-4030.2016. 08.003.
[21] 王春雨,黄维肖,袁义厘,等. 失禁性皮炎皮肤损伤评估量表的汉化及信度、效度评价[J]. 中国护理管理,2016,16(3):337-339,340. DOI: 10.3969/j.issn.1672-1756.2016. 03.014.
[22] 王泠,郑小伟,马蕊,等. 国内外失禁相关性皮炎护理实践专家共识解读[J]. 中国护理管理,2018,18(1):3-6. DOI: 10.3969/j.issn.1672-1756.2018.01.002.
[23] 张学军,郑捷.皮肤性病学[M].9版.北京:人民卫生出版社,2018.
[24] 许彩云,孙红玲,夏金萍. 造口袋配合低负压引流管理大便失禁相关性皮炎的效果观察[J]. 护理与康复,2015,14(2):154-156. DOI: 10.3969/j.issn.1671-9875.2015.02.018.
[25] 闵小彦,郑晓倩,黄凡,等. 双套管灌洗联合造口袋低负压吸引预防ICU大便失禁患者失禁性皮炎的效果观察[J]. 护理学报,2019,26(5):51-53. DOI: 10.16460/j.issn1008-9969. 2019.05.051.
[26] 杨璐丹,张思为,谢曼英,等. 茶树油治疗老年重症患者失禁性皮炎的近远期疗效[J]. 中国老年学杂志,2020,40(22):4813-4815. DOI: 10.3969/j.issn.1005-9202.2020.22.035.
[27] 蒋璐瑶,吕祺美,陈天喜. 珍黄胶囊外敷治疗脑卒中失禁性皮炎疗效观察[J]. 浙江临床医学,2023,25(2):241-243.
[28] 江燕,刘云,陈智辉. 莫匹罗星软膏联合赛肤润治疗脑卒中失禁性皮炎的临床效果[J]. 临床合理用药,2023,16(7):108-111. DOI: 10.15887/j.cnki.13-1389/r.2023.07.033.
[29] 袁源,杨宝莲. 3M液体敷料联合造口护肤粉和中药湿敷对老年失禁性皮炎患者康复及舒适度的影响[J]. 临床医药实践,2022,31(5):376-378. DOI: 10.16047/j.cnki.cn14-1300/r.2022.05.016.
[30] 孙钰,郭倩,李利铭. 蒙脱石散外敷联合赛肤润修复失禁性皮炎患者皮肤损伤的效果[J]. 护理实践与研究,2020,17(12):138-139. DOI: 10.3969/j.issn.1672-9676.2020. 12.053.
[31] 江鸿展,陈丽娟,申嘉丽,等. 老年患者失禁相关性皮炎危险因素的Meta分析[J]. 中华护理杂志,2023,58(4):471-477. DOI: 10.3761/j.issn.0254-1769.2023.04.013.
[32] 温芳芳,何莹华,张凤英,等. 基于藻酸盐银离子敷料与贝复新的综合护理改善肠造口黏膜皮肤分离的临床效果[J]. 广东医学,2019,40(9):1333-1336. DOI: 10.13820/j.cnki.gdyx.20184301.

贝复新联合肛门袋负压引流冲洗装置在ICU失禁相关性皮炎患者中的应用

Application of bovine basic fibroblast growth factor gel combined with anal bag negative pressure drainage and flushing device in nursing care for ICU patients with incontinence-associated dermatitis

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