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循证皮肤护理和水胶体敷料预防鼻胃管相关压力性损伤的效果:一项随机对照临床试验。

The effect of evidence-based skin care and hydrocolloid dressing in the prevention of nasogastric tube-related pressure injury: A randomized controlled clinical trial.

作者信息

Yeşilyurt Maide, Yüksel Serpil, Yosunkaya Alper

机构信息

Aksaray University, Health Services Vocational School, Aksaray, Turkey.

Necmettin Erbakan University, Faculty of Nursing, Department of Surgical Nursing, Konya, Turkey.

出版信息

J Tissue Viability. 2024 Nov;33(4):889-894. doi: 10.1016/j.jtv.2024.09.001. Epub 2024 Sep 12.

Abstract

OBJECTIVE

The aim of this study is to determine the effect of evidence-based skin care and hydrocolloid dressing in the prevention of nasogastric (NG) tube-related pressure injuries (PIs).

DESIGN

This study was a three-arm parallel-group randomized controlled clinical trial registered on Clinicaltrials.gov (NCT04682925).

METHODS

The study was conducted with 102 patients who underwent NG tube insertion immediately after admission to the anesthesiology and reanimation intensive care unit of a university hospital in Turkey. Patients were randomly assigned to three groups: a control arm (n = 34), a hydrocolloid dressing arm (n = 34), and a skin care arm (n = 34). Patients in the hydrocolloid dressing arm received daily application of hydrocolloid dressing to the nasal mucosa and alae nasi where the NG tube was inserted. Patients in the skin care arm received skin care interventions in preventing PIs twice daily. No interventions were administered to the control group.

RESULTS

No NG tube-related PIs occurred in any patients in the hydrocolloid dressing arm. However, PIs occurred in 97.1 % of patients in the control arm and 94.1 % of patients in the skin care arm. According to the results of regression analysis, failure to apply hydrocolloid dressing increased the risk of NG tube-related PIs by 20.3 times [OR = 20.301, 95 % CI = 6.335-65.053, p < 0.001]. Additionally, a one-unit increase in the duration of ventilation days reduced the risk of NG tube-related PIs by 17.7 % (1-0.823) [OR = 0.823 (95 % CI = 0.684-0.989), p = 0.038].

CONCLUSION

Results revealed that hydrocolloid dressing is effective in preventing of NG tube-related PIs, whereas skin care did not demonstrate the same effectiveness.

摘要

目的

本研究旨在确定循证皮肤护理和水胶体敷料在预防鼻胃管相关压力性损伤中的作用。

设计

本研究是一项三臂平行组随机对照临床试验,已在Clinicaltrials.gov(NCT04682925)上注册。

方法

该研究对土耳其一家大学医院麻醉与复苏重症监护病房入院后立即接受鼻胃管插入术的102例患者进行。患者被随机分为三组:对照组(n = 34)、水胶体敷料组(n = 34)和皮肤护理组(n = 34)。水胶体敷料组患者每天在插入鼻胃管的鼻黏膜和鼻翼处应用水胶体敷料。皮肤护理组患者每天接受两次预防压力性损伤的皮肤护理干预。对照组不进行任何干预。

结果

水胶体敷料组的任何患者均未发生鼻胃管相关压力性损伤。然而,对照组97.1%的患者和皮肤护理组94.1%的患者发生了压力性损伤。根据回归分析结果,未应用水胶体敷料使鼻胃管相关压力性损伤的风险增加了20.3倍[比值比(OR)= 20.301,95%置信区间(CI)= 6.335 - 65.053,p < 0.001]。此外,通气天数每增加1天,鼻胃管相关压力性损伤的风险降低17.7%(1 - 0.823)[OR = 0.823(95% CI = 0.684 - 0.989),p = 0.038]。

结论

结果显示,水胶体敷料在预防鼻胃管相关压力性损伤方面有效,而皮肤护理未显示出相同的效果。

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