Sardesai Smeeta R, Kornacka Maria K, Walas Wojciech, Ramanathan Rangasamy
Department of Pediatrics, University of Southern California, Los Angeles, USA.
J Matern Fetal Neonatal Med. 2011 Feb;24(2):197-203. doi: 10.3109/14767051003728245. Epub 2010 Jun 14.
Although neonatal care has become more and more meticulous with significant changes in technology in the neonatal intensive care unit (NICU) in the past 50 years, iatrogenic cutaneous injuries continue to occur. Although the incidence of severe injuries is decreasing because the more difficult procedures are being replaced by improved techniques, skin injuries have not yet been completely eliminated. However, the nature and causes of cutaneous injuries have changed, and the injuries are frequent but generally minor. The major risk factors are low birth weight, gestational age, length of stay, a central venous line, mechanical ventilation, and support with continuous positive airway pressure. The rate of iatrogenic events is about 57% at gestational ages of 24-27 weeks, compared with 3% at term. There are no current comprehensive reviews of iatrogenic cutaneous injury. The purpose of this review is to describe the iatrogenic cutaneous injuries that may occur in the newborns as a consequence of perinatal and postnatal medical procedures. With increased survival of extremely-low-birth-weight (ELBW) infants and changing modes of management in the NICU, neonatologists must make every effort to recognize injuries and prevent their occurrence in the NICU.
尽管在过去50年里，随着新生儿重症监护病房（NICU）技术的显著变化，新生儿护理变得越来越精细，但医源性皮肤损伤仍不断发生。虽然由于更复杂的操作被改进技术所取代，严重损伤的发生率在下降，但皮肤损伤尚未完全消除。然而，皮肤损伤的性质和原因已经改变，损伤虽频繁但一般较轻微。主要危险因素包括低出生体重、胎龄、住院时间、中心静脉置管、机械通气以及持续气道正压通气支持。孕24 - 27周时医源性事件发生率约为57%，而足月儿为3%。目前尚无关于医源性皮肤损伤的全面综述。本综述的目的是描述围产期和产后医疗操作可能导致的新生儿医源性皮肤损伤。随着极低出生体重（ELBW）婴儿存活率的提高以及NICU管理模式的变化，新生儿科医生必须竭尽全力识别损伤并预防其在NICU发生。
