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新生儿重症监护病房婴儿医源性皮肤损伤:22 家中国单位的调查。

Iatrogenic skin injuries in infants admitted to neonatal intensive care units: An investigation in 22 Chinese units.

机构信息

Fujian Key Laboratory of Neonatal Diseases, Xiamen, 361006, China; Children's Hospital of Fudan University, Shanghai, 201102, China; Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen, 361006, China; Key Laboratory of Neonatal Diseases, Xiamen, 361006, China.

Fujian Key Laboratory of Neonatal Diseases, Xiamen, 361006, China; Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen, 361006, China; Key Laboratory of Neonatal Diseases, Xiamen, 361006, China.

出版信息

J Tissue Viability. 2024 May;33(2):197-201. doi: 10.1016/j.jtv.2024.03.007. Epub 2024 Mar 27.

Abstract

OBJECTIVE

To investigate the incidence of iatrogenic skin injuries in neonates across 22 neonatal intensive care units (NICUs) in China.

DESIGN

Prospective study.

SETTING

22 NICUs in China.

PATIENTS

Infants admitted to NICU.

INTERVENTIONS

None.

MEASUREMENTS

The "Iatrogenic Skin Injuries Data Collection Form of infants" were used to collect the data during hospitalization.

MAIN RESULTS

A total of 8126 neonates who were hospitalized in 22 tertiary hospitals across 15 provinces, cities, and autonomous regions of China between December 1, 2019 and January 31, 2020 were analyzed. Five hundred and twenty-one infants had iatrogenic skin injuries, including 250 with diaper dermatitis (47.98%), 70 with physicochemical factor-related skin lesions (PCFRSIs) (13.44%), 81 with medical device-related pressure injuries (MDRPIs) (15.55%), and 69 with medical adhesive-related skin injuries (MARSIs) (13.24%), accounting for 91% of the total number of iatrogenic injuries. Among these, diaper dermatitis was closely related to the skin and feeding status. Furthermore, the risk was higher among neonates who had skin damage upon admission or were already fully fed orally. The influencing factors of MDRPIs and MARSIs were similar. They were negatively associated with gestational age and birth weight, and were closely related to the presence of various tubes.

CONCLUSIONS

Diaper dermatitis, PCFRSIs, MDRPIs, and MARSIs were the four common types of iatrogenic skin injuries in newborns. The various types of iatrogenic skin injuries were influenced by varying factors. Specialized nursing measurements can reduce the likelihood of these injuries.

摘要

目的

调查中国 22 家新生儿重症监护病房(NICU)新生儿医源性皮肤损伤的发生率。

设计

前瞻性研究。

地点

中国 22 家 NICU。

患者

入住 NICU 的婴儿。

干预措施

无。

测量方法

使用“婴儿医源性皮肤损伤数据采集表”在住院期间收集数据。

主要结果

对 2019 年 12 月 1 日至 2020 年 1 月 31 日期间在中国 15 个省、市、自治区的 22 家三级医院住院的 8126 例新生儿进行了分析。521 例新生儿发生医源性皮肤损伤,其中尿布性皮炎 250 例(47.98%),理化因素相关皮肤损伤 70 例(13.44%),医疗器械相关性压力性损伤 81 例(15.55%),医用粘胶相关性皮肤损伤 69 例(13.24%),占医源性损伤总数的 91%。其中,尿布性皮炎与皮肤和喂养状况密切相关。此外,入院时皮肤受损或已完全经口喂养的新生儿发生风险更高。MDRPI 和 MARSIs 的影响因素相似,与胎龄和出生体重呈负相关,与各种管道的存在密切相关。

结论

尿布性皮炎、理化因素相关皮肤损伤、医疗器械相关性压力性损伤和医用粘胶相关性皮肤损伤是新生儿常见的四种医源性皮肤损伤类型。各种医源性皮肤损伤受不同因素影响,采取专科护理措施可降低其发生风险。

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