新生儿医用粘胶相关皮肤损伤危险因素分析及其护理对策

目的探讨新生儿医用粘胶相关性皮肤损伤(MARSI)危险因素和护理对策。方法选取2016年4月至2018年5月在本院接受治疗的新生儿483例为研究对象,统计其发生MARSI例数和损伤类型,依据是否发生MARSI将患儿分成MARSI组61例和未发生MARSI组422例,记录患儿温箱、胎龄、抢救台、出生体质量、潮湿多汗、蓝光治疗、感染、留置胃管、禁食、经外周静脉置入中心静脉导管(PICC)、水肿及皮肤干燥情况,对影响患儿发生MARSI的因素进行多因素logistic回归分析。结果患儿皮肤受损类型依次为表皮剥脱伤(6.21%)、皮肤撕裂伤(3.73%)、接触性皮炎1.45%。蓝光治疗、留置胃管、出生体质量<2200 g、胎龄<30周及皮肤干燥为患儿发生MARSI的独立危险因素(P<0.05)。结论临床新生儿MARSI发生率较高,且影响因素多,医护人员应采用有针对性护理措施,加强防范,以降低新生儿MARSI的发生率。

Analysis of neonatal medical adhesive-related skin injury risk factors and its nursing countermeasures

Objective To explore the risk factors of neonatal medical adhesive-related skin injury(MARSI)and its nursing countermeasures.Methods To select 483 cases of neonates who were treated in our hospital from April 2016 to May 2018 as the study subjects.The number of MARSI cases and the type of injury were counted.The children were divided into 61 cases of MARSI group and 422 cases of without MARSI group according to whether MARSI occurred.The children patients'situation such as incubator,gestational age,rescue table,birth weight,wet and sweaty,blue light treatment,infection,indwelling gastric tube,fasting,peripherally inserted central venous catheters(PICC),edema and dry skin,etc.were recorded to implement multivariate logistic regression analysis.Results The types of skin damage in children patients were epidermal peeling(6.21%),laceration(3.73%),and contact dermatitis(1.45%).The blue light treatment,indwelling gastric tube,birth weight<2,200 g,gestational age<30 weeks,and dry skin were the independent risk factors for occurrence of MARSI in children patients(P<0.05).Conclusion The incidence of MARSI in clinical neonates was high and there were many influencing factors.Medical staff should adopt targeted nursing measures and strengthen prevention to reduce the incidence of neonatal MARSI.