Zhao Huihan, He Yu, Huang Huiqiao, Ling Ying, Zhou Xuemei, Wei Qin, Lei Yonghong, Ying Yanping
1 Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi - China.
2 Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi - China.
J Vasc Access. 2018 Jan;19(1):23-27. doi: 10.5301/jva.5000805.
The aim of our study was to identify the prevalence and risk factors of medical adhesive-related skin injuries (MARSI) at peripherally inserted central catheters (PICC) insertion site in oncology patients.
A cross-sectional observational study lasting two weeks was carried out in four inpatient departments. Skin assessment data and photographs of skin were collected during PICC maintenance. Other related information came from medical records. The skin injuries were classified by dermatologists and PICC specialized nurses. MARSI prevalence was calculated and the associated factors were analyzed statistically.
All 419 patients were included. The prevalence of total MARSI at PICC insertion site was 125, (29.83%), including mechanical skin injury (73, 17.42%), contact dermatitis (CD) (39, 9.31%), moisture-associated skin damage (11, 2.63%), folliculitis (2, 0.48%). Multivariate analysis identified two independent risk factors for MARSI including age ≥50 y (p = 0.031, odds ratio [OR] = 4.521, 95% confidence interval [CI] [1.389, 20.620]) and hematologic malignancies (p = 0.000, OR = 2.514, 95% CI [1.590,3.97]. Oxaliplatin and arsenic trioxide infusion through PICC, history of skin allergies was associated with CD, with p = 0.020, OR = 3.492, 95% CI (1.220, 9.990); p = 0.003, OR = 4.565, 95% CI (1.661,12.547); p = 0.000, OR = 12.333, 95% CI (3.669, 41.454), respectively.
MARSI at PICC insertion site is a frequent event among oncology patients. Epidemiological data and independent risk factors are presented in our study, which provide a basis for future study in this area.
我们研究的目的是确定肿瘤患者经外周静脉穿刺中心静脉置管（PICC）穿刺部位与医用胶粘剂相关的皮肤损伤（MARSI）的患病率及危险因素。
在四个住院科室开展了一项为期两周的横断面观察性研究。在PICC维护期间收集皮肤评估数据及皮肤照片。其他相关信息来自病历。皮肤损伤由皮肤科医生和PICC专科护士进行分类。计算MARSI患病率并对相关因素进行统计学分析。
共纳入419例患者。PICC穿刺部位总的MARSI患病率为125例（29.83%），包括机械性皮肤损伤（73例，17.42%）、接触性皮炎（CD）（39例，9.31%）、湿性皮肤损伤（11例，2.63%）、毛囊炎（2例，0.48%）。多因素分析确定了MARSI的两个独立危险因素，包括年龄≥50岁（p = 0.031，比值比[OR]=4.521，95%置信区间[CI][1.389，20.620]）和血液系统恶性肿瘤（p = 0.000，OR = 2.514，95%CI[1.590，3.97]）。通过PICC输注奥沙利铂和三氧化二砷、皮肤过敏史与CD相关，p分别为0.020，OR = 3.492，95%CI（1.220，9.990）；p = 0.003，OR = 4.565，95%CI（1.661，12.547）；p = 0.000，OR = 12.333，95%CI（3.669，41.454）。
PICC穿刺部位的MARSI在肿瘤患者中很常见。我们的研究给出了流行病学数据和独立危险因素，为该领域未来的研究提供了依据。
