门诊外周中心置管患者医用粘胶相关皮肤损伤的发生率及危险因素分析

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability Pub Date : 2025-02-25 DOI:10.1016/j.jtv.2025.100875

Qi Xia , Xin Chen , QingHua Ma , DingDing Zhang

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引用次数: 0

摘要

目的：为了保护导管，皮肤暴露在粘接剂下容易发生医用粘接剂相关皮肤损伤（MARSI）。这些损伤的发生和危险因素以前没有估计在门诊患者外周插入中心导管。本研究的主要目的是描述MARSI的特征，并量化PICC门诊患者MARSI的三种发病率。方法选取2020年10月至12月PICC门诊患者299例。数据由中国成都四川省医学科学院和四川省人民医院收集。在中国西部某三级综合医院PICC中心进行为期3个月的横断面调查，分析导管部位MARSI的发生及相关因素。专业护士在导管维持期间观察和评估皮肤状况，并收集可能与MARSI发生相关的患者数据。采用多变量分析对自变量与MARSI之间的关系进行统计分析。结果外周中心置管患者MARSI发生率为14.7%。统计分析发现，维修人员（χ2 = 8.683, P = 0.003）、MARSI病史（χ2 = 4.332, P = 0.037）、外固定装置（χ2 = 4.227, P = 0.04）与MARSI的发生有显著相关性。50岁以上患者（χ2 = 4.183, P = 0.041）和使用透明敷料（χ2 = 6.782, P = 0.009）与张力损伤相关。多因素分析显示外固定装置的使用(OR, 2.987；95% CI, 1.044 ~ 8.547；P = 0.041)是MARSI的独立危险因素。结论门诊PICC患者发生MARSI的风险较高。为了预防和控制MARSI，必须提高维护人员的专业技能，并特别注意有MARSI病史的患者和50岁以上的患者。此外，还应考虑使用外固定装置和透明敷料。

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Incidence and risk factors of medical adhesive-related skin injuries in outpatients with peripherally inserted central catheters

Aims

Skin exposed to the adhesives to protect catheters is prone to Medical Adhesive-Related Skin Injuries (MARSI). Occurrence of these injuries and the risk factors have not been estimated previously in outpatients with peripherally inserted central catheters. The primary aim of this study was to delineate the characteristics of MARSI and quantify 3 types of incidence rates of MARSI among outpatients with PICC placements.

Methods

The study sample included 299 outpatients with PICC placements from October to December 2020. The data were collected at the Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital in Chengdu, China.A three-month cross-sectional survey was conducted at the PICC center of a tertiary general hospital in Western China to analyze the occurrence of MARSI at the catheterization site and related factors. Professional nurses observed and assessed skin conditions during catheter maintenance and collected patient data that could be associated with MARSI occurrence. The relationship between independent variables and MARSI was statistically analyzed using multivariate analysis.

Results

Among outpatients with peripherally inserted central catheters,the incidence rate of MARSI was 14.7 %. Statistical analysis revealed that maintenance personnel (χ² = 8.683, P = 0.003), MARSI history (χ² = 4.332, P = 0.037), external fixation devices (χ² = 4.227, P = 0.04) were significantly associated with the occurrence of MARSI. Moreover, patients over the age of 50 (χ² = 4.183, P = 0.041) and the use of transparent dressing (χ² = 6.782, P = 0.009) were found to be associated with tension injuries. A multivariate analysis showed that the use of external fixation devices (OR, 2.987; 95 % CI, 1.044 to 8.547; P = 0.041) was an independent risk factor for MARSI.

Conclusions

Patients with PICC in the outpatient department are at a high risk of developing MARSI. To prevent and control MARSI,it is essential to enhance the professional skills of maintenance staff and to pay special attention to patients with a history of MARSI and those over the age of 50. Additionally,the use of external fixation devices and transparent dressings should also be considered.

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来源期刊

Journal of tissue viability DERMATOLOGY-NURSING

CiteScore

3.80

自引率

16.00%

发文量

110

审稿时长

>12 weeks

期刊介绍： The Journal of Tissue Viability is the official publication of the Tissue Viability Society and is a quarterly journal concerned with all aspects of the occurrence and treatment of wounds, ulcers and pressure sores including patient care, pain, nutrition, wound healing, research, prevention, mobility, social problems and management. The Journal particularly encourages papers covering skin and skin wounds but will consider articles that discuss injury in any tissue. Articles that stress the multi-professional nature of tissue viability are especially welcome. We seek to encourage new authors as well as well-established contributors to the field - one aim of the journal is to enable all participants in tissue viability to share information with colleagues.