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使用两种评分系统定义的造口周围皮肤疾病发生率和严重程度的风险因素。

Risk factors for the incidence and severity of peristomal skin disorders defined using two scoring systems.

机构信息

Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.

Wound, Ostomy and Continence Nurse, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.

出版信息

Surg Today. 2020 Mar;50(3):284-291. doi: 10.1007/s00595-019-01876-9. Epub 2019 Sep 11.

Abstract

PURPOSE

Peristomal skin disorders (PSDs) are common stoma-related complications. However, there is no standard method for the evaluation of PSDs, and the true incidence is unclear. There are also no reports on risk factors for severe PSDs. Therefore, this study was performed to analyze the incidence of PSD in temporary loop stoma based on the DET score and ABCD-stoma score and to determine the risk factors for all and severe PSDs.

METHODS

A retrospective analysis of patient and surgical characteristics was carried out in 333 consecutive cases of stoma creation with loop ileostomy or colostomy performed at our hospital from January 2014 to December 2016.

RESULTS

PSDs were diagnosed in 262 patients (78.7%), including 79 (23.7%) and 71 (21.3%) that were defined as severe based on DET and ABCD-stoma scores, respectively. Multivariate analyses showed that parastomal hernia was an independent risk factor for severe PSD defined by DET score and that adjuvant chemotherapy was an independent risk factor for severe PSD defined by the ABCD-stoma score.

CONCLUSIONS

Severe PSDs are associated with parastomal hernia when diagnosed by the DET score and with adjuvant chemotherapy when diagnosed by the ABCD-stoma score.

摘要

目的

造口周围皮肤疾病(PSD)是常见的造口相关并发症。然而,目前尚无评估 PSD 的标准方法,其真实发病率也不清楚。此外,也没有关于严重 PSD 危险因素的报道。因此,本研究旨在基于 DET 评分和 ABCD-造口评分分析临时袢式肠造口 PSD 的发生率,并确定所有和严重 PSD 的危险因素。

方法

对 2014 年 1 月至 2016 年 12 月我院连续 333 例行回肠或结肠造口术患者的临床和手术特征进行回顾性分析。

结果

262 例(78.7%)患者诊断为 PSD,其中 79 例(23.7%)和 71 例(21.3%)根据 DET 和 ABCD-造口评分分别定义为严重 PSD。多因素分析显示,造口旁疝是 DET 评分定义的严重 PSD 的独立危险因素,辅助化疗是 ABCD-造口评分定义的严重 PSD 的独立危险因素。

结论

根据 DET 评分诊断严重 PSD 与造口旁疝有关,根据 ABCD-造口评分诊断严重 PSD 与辅助化疗有关。

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