徐一松

[摘要] 目的 观察综合护理干预预防ICU失禁性皮炎的护理效果。 方法 选取2015年1月～2017年1月我院ICU住院治疗的患者80例，随机分为对照组和干预组，每组40例。对照组采用常规护理，干预组实施综合护理，应用统计学方法比较两组患者的IAD的发生率、愈合时间及护理满意度。 结果 干预组发生IAD共4例，占10.0%，对照组发生IAD共12例，占30.0%，干预组患者重度IAD发生率25.0%，明显低于对照组的66.7%，组间差异具有统计学意义（P<0.05）。干预组护理效果的总有效率达97.5%，明显高于对照组的77.5 %，组间差异具有统计学意义（P<0.05）。干预组患者IAD 愈合时间（4.38±1.13）d，明显短于对照组患者IAD 愈合时间（5.39±1.82）d，组间比较，差异具有统计学意义（P<0.05）。干预组患者的护理满意度为97.5%，明显高于对照组（P<0.05）。 结论 综合护理干预有利于降低ICU失禁性皮炎的发生率，护理效果好，愈合快，护理满意度高。

[关键词] ICU；失禁性皮炎；综合护理干预；护理满意度

[中图分类号] R473.75 [文献标识码] B [文章编号] 1673-9701（2018）10-0141-03

Clinical observation on prevention of incontinence-associated dermatitis in ICU through integrated care intervention

XU Yisong

The First Intensive Care Unit， Tongde Hospital of Zhejiang Province， Hangzhou 310012， China

[Abstract] Objective To investigate the effectiveness of integrated care intervention on the prevention of incontinence-associated dermatitis（IAD） in intensive care units （ICU）. Methods 80 patients in ICU of our hospital from January 2015 to January 2017 were selected and randomized into control group and observation group（40 patients each）. Patients in control group received the routine nursing care， while patients in observation group received integrated care. The incidence of IAD， healing time and nursing satisfaction in two groups were compared by using statistical methods. Results There were 4 cases of IAD in observation group（10.0%）， while there were 12 cases in control group （30.0%）. The incidence of severe IAD in observation group（25.0%） was significantly lower than that in control group（66.7%）， the difference was significant（P<0.05）. The overall rate of nursing effectiveness in observation group（97.5%） was significantly higher than that in control group（77.5%）， the difference was significant（P<0.05）. The healing time of IAD in observation group （4.38±1.13 d） was statistically shorter than that in control group （5.39±1.82 d）， the difference was significant （P<0.05）. The nursing satisfaction of patients in observation group（97.5%） was significantly better than that in control group（P<0.05）. Conclusion Integrated care intervention could help reduce the incidence and healing time of IAD in ICU as well as improve the nursing effectiveness and satisfaction.

[Key words] ICU； Incontinence-associated dermatitis； Integrated care intervention； Nursing satisfaction

失禁性皮炎（incontinence-associated dermatitis，IAD）是失禁患者常見的并发症之一，因皮肤长期暴露在大小便中，受尿液与粪便的侵蚀出现的一种刺激性皮炎，可引起肛门、会阴部周围皮肤受损，出现发红、发亮、表面破损及散布性红疹等[1-2]。若不能及时给予有效的治疗与护理，可导致患者皮肤出现溃疡、糜烂，增加患者的痛苦及住院时间等[3]。早期进行护理和预防，有利于降低住院患者IAD发生率、促进愈合。本研究旨在观察综合护理干预预防ICU失禁性皮炎的护理效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年1月～2017年1月我院ICU住院治疗的患者80例，排除合并心脑血管疾病、糖尿病及恶性肿瘤等患者及入院时有失禁相关性皮肤损伤、会阴部皮肤损伤者、排除精神疾病者。80例ICU住院患者随机分为对照组和干预组，每组40例。对照组40例，男21例，女19例，年龄 53～89 岁，平均年龄（67.1±5.2）岁；其中，大小便均失禁9 例；干预组40例，男22例，女18例，年龄 52～92岁，平均年龄（68.2±7.3）岁；其中，大小便均失禁11 例；……