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护理学报 ›› 2019, Vol. 26 ›› Issue (17): 1-5.doi: 10.16460/j.issn1008-9969.2019.17.001

• 研究生园地 •    下一篇

肿瘤患者PICC置入部位医用粘胶相关性皮肤损伤影响因素的队列研究

王琴1, 陈金1, 魏力1,2   

  1. 1.天津医科大学总医院,天津 300052;
    2.天津医科大学总医院空港医院,天津 300308
  • 收稿日期:2019-04-06 发布日期:2020-07-13
  • 通讯作者: 魏 力（1966-）,女,天津人,本科学历,主任护师,护理部主任。 E-mail：weili066100@126.com
  • 作者简介:王 琴（1993-）,女,四川宣汉人,本科学历,硕士研究生在读。

Cohort Study on Influence Factors of Medical Adhesive-related Skin Injury in PICC Insertion Site of Tumor Patients

WANG Qin1, CHEN Jin1, WEI Li1,2   

  1. 1. General Hospital, Tianjin Medical University, Tianjin 300052, China;
    2. Airport Hospital of General Hospital,Tianjin Medical University, Tianjin 300308, China
  • Received:2019-04-06 Published:2020-07-13

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摘要： 目的 探讨医用粘胶相关性皮肤损伤（medical adhesive related skin injury,MARSI）在PICC肿瘤患者中的发生情况及影响因素,为降低医用粘胶相关性皮肤损伤的发生提供护理依据。方法 采用前瞻性队列研究的方法,选取2018年4月1日—11月20日在天津市某三级甲等医院行PICC置管的396例肿瘤患者作为研究对象,调查医用粘胶相关性皮肤损伤的发生率,并分析医用粘胶相关性皮肤损伤类型、医用粘胶相关性皮肤损伤发生部位及影响因素。结果 肿瘤患者医用粘胶相关性皮肤损伤发生率为26.8%（106/396）;医用粘胶相关性皮肤损伤类型以接触性皮炎 13.9%（55/396）以及机械性皮肤损伤中的张力性损伤/水疱6.3%（25/396）为主,其次为潮湿相关性皮肤损伤1.3%（5/396）,毛囊炎1.0%（4/396）。医用粘胶相关性皮肤损伤多发生在贴膜下皮肤63.2%（67/106）。多因素Logistic回归分析发现PICC导管相关感染（P<0.001,OR=3.271,95%CI：1.697~6.306）、穿刺次数（P=0.018,OR=2.474,95%CI：1.171~5.226）、导管维护周期延迟（P=0.018,OR=2.537,95%CI：1.176~5.473）是肿瘤PICC患者发生医用粘胶相关性皮肤损伤的危险因素。结论 肿瘤患者PICC置管部位医用粘胶相关性皮肤损伤发生率较高,且好发于贴膜下皮肤;医用粘胶相关性皮肤损伤类型以接触性皮炎和机械性皮肤损伤居多;而感染、穿刺次数、导管维护周期延迟是医用粘胶相关性皮肤损伤发生的危险因素。

关键词: 肿瘤患者, PICC, 医用粘胶相关性皮肤损伤, 队列研究

Abstract: Objective To investigate the occurrence and influence factors of medical adhesive-related skin injury (MARSI) at PICC insertion site in tumor patients, and to provide nursing reference for reducing the occurrence of MARSI. Methods A prospective cohort study was conducted and 396 tumor patients with PICC were selected in a tertiary grade A hospital in Tianjin from April 1st to November 20th, 2018. The incidence of MARSI was investigated, and the type and location of MARSI, and its influencing factors were analyzed. Results The incidence of MARSI in tumor patients was 26.8%(106/396). The main type of skin injury was contact dermatitis, accounting for 13.9% (55/396) and tension injury or blister in mechanical skin injury, accounting for 6.3%(25/396), followed by wet-related skin injury (1.3%, 5/396) and folliculitis (1.0%, 4/396). MARSI occurred mostly in the skin under the film (63.2%, 67/106). Multivariate analysis showed PICC-related infections (P<0.001, OR=3.271, 95%CI:1.697~6.306), times of puncture (P=0.018, OR=2.474, 95%CI:1.171~5.226) and delay in maintenance period (P=0.018, OR=2.537, 95%CI:1.176~5.473) were risk factors for MARSI in tumor patients with PICC. Conclusion The incidence of MARSI in PICC catheter site is higher in tumor patients, and it frequently occurs in the skin under the film. Contact dermatitis and mechanical skin injury are main type of MARSI and PICC-related infection, times of puncture and the delay of catheter maintenance period are risk factors for MARSI.

Key words: tumorous patient, PICC, medical adhesive-related skin injury, cohort study

中图分类号: 

  • R473.73
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