不同护理措施预防重症患者失禁相关性皮炎的对比研究

目的 探讨4种皮肤护理方案预防重症患者失禁相关性皮炎（incontinence associated dermatitis，IAD）的效果。 方法 入选112例ICU失禁患者，随机分为A、B、C、D4个组，每组28例，在一致性皮肤护理方法基础上，A组会阴部皮肤每12h喷涂1次硅酮敷料，B组每8h喷涂1次硅酮敷料；C组每12h喷涂一次皮肤保护膜和D组每8h喷涂1次皮肤保护膜，连续干预7d，观察IAD发生率、发生时间及其严重度分级。 结果 4组患者IAD总发生率26.78%，硅酮敷料A组和 B组IAD发生率低于皮肤保护膜C组和D组（P＜0.05）；相同敷料不同使用频率比较，8h和12h之间比较IAD发生率无统计学意义（P>0.05）。 4组IAD发生时间和严重程度比较无统计学意义（P>0.05）。 结论 硅酮敷料每8h或12h使用1次能降低IAD发生率，可根据失禁频度选择硅酮敷料使用的频率。

Clinical studies of four skin care interventions for prevention of incontinence associated dermatitis

Objective To compare the effects of 4 skin nursing interventions on prevention of severe incontinent associated dermatitis （IAD）. Methods A total of 112 incontinence patients in ICU were randomly divided into Group A，B，C and D，respectively. Apart from identical skin care in all groups，for Group A，silicone dressing on perineal skin was applied once every 12h；for Group B，silicone dressing was applied every 8h；for Group C，Barrier fi lm on perineal skin was applied once every 12h；for Group D，Barrier film was applied every 8h. All interventions were conducted for 7 days，and rate of IAD，time to occur and severity was recoded. Results The total rate of IAD was 26.78%. The rates of IAD in Group A and B were lower than those in Group C and D（P<0.05）； for the same dressing with different frequency，there was no statistically significant difference regarding the rate of IAD. The differences about time to occur and severity in 4 groups had no statistical significance. Conclusion Applying silicone dressing every 8 hours and 12 hours can reduce rate of IAD. The frequency of applying silicone dressing can vary according to the frequency of incontinence.