NICU新生儿医源性皮肤损伤的现况及影响因素分析

目的调查新生儿重症监护病房(NICU)患儿医源性皮肤损伤(ISIs)的现况,并分析其影响因素。方法于2020年10月至12月,采用自行设计的NICU患儿医源性皮肤损伤资料收集表对重庆医科大学附属儿童医院NICU患儿ISIs情况进行前瞻性横断面调查,并分析其影响因素。结果共333例患儿纳入本调查,其中63例患儿出现ISIs,发生率为18.9%;常见ISIs的原因主要包括尿布性皮炎、持续气道正压鼻塞压迫、皮肤皱褶处皮炎、备皮刮伤、撕拉胶布和电极片所致皮肤损伤等;多因素Logistic回归分析结果显示,胎龄和是否行无创机械通气是新生儿ISIs的独立危险因素。结论新生儿ISIs发生率较高,胎龄越小越有可能发生ISIs,护士应重视ISIs的预防。

Investigation on the current situation and risk factors of iatrogenic skin injury in neonatal intensive care unit

Objective To investigate the current situation of iatrogenic skin injuries(ISIs)in neonatal intensive care unit(NICU)of a tertiary hospital and analyze the risk factors.Methods From October to December of 2020,a self-designed neonatal iatrogenic skin injury data collection table was used to conduct a prospective cross-sectional survey in neonatal intensive care unit of Children's Hospital of Chongqing Medical University.The risk factors of ISIs were analyzed as well.Results A total of 333 neonates were included in the survey.Sixty-three of them had ISIs,with the incidence rate of 18.9%.The common causes of ISIs mainly included diaper dermatitis,nasal congestion caused by continuous positive airway pressure,intertriginous dermatitis,skin preparation and scraping,skin injury caused by tearing tape and electrode piece.The results of multivariate regression analysis showed that gestational age and the use of noninvasive mechanical ventilation were the independent risk factors for ISIs in neonates.Conclusions The incidence of ISIs is higher in neonates.The younger the gestational age is,the more likely ISIs will occur.Attention should be paid to the prevention of ISIs.