摘要
目的系统评价肠造口周围潮湿相关性皮肤损伤(PMASD)的发生率及其危险因素。方法计算机检索知网、万方、维普、EMbase、PubMed、Web of Science、Cochrane Library数据库,检索有关肠PMASD的发生影响因素研究,检索时限至2023年10月。将纳入文献采用Stata软件进行meta分析。结果共纳入11篇文献,涉及3222例患者,肠PMASD的发生率为41%[95%可信区间(95%CI)0.30~0.51],纳入危险因素22个,可合并的危险因素16个,年龄[优势比(OR)=1.06,95%CI 1.03~1.09]、性别(OR=1.38,95%CI 1.04~1.84)、文化程度(OR=4.17,95%CI 2.27~7.68)、患者放疗史(OR=5.42,95%CI 3.89~7.56)、糖尿病(OR=3.80,95%CI 1.03~1.09)、造口种类(OR=3.14,95%CI 2.20~4.48)、佩戴的造口袋类型(OR=4.46,95%CI 1.95~10.20)、造口并发症(OR=1.98,95%CI 2.81~3.17)、患者造口自护能力(OR=2.65,95%CI 3.41~6.36)、造口高度(OR=1.42,95%CI 1.30~1.94)、底盘区域伤口(OR=4.97,95%CI 3.50~7.06)、底盘渗漏大于3次(OR=2.97,95%CI 1.59~5.54)、手术方式(OR=2.12,95%CI 1.51~2.97)、体重上升或下降不超过5 kg(OR=1.29,95%CI 1.17~1.42)均与肠PMASD发生有关。结论现有证据表明,肠PMASD发生率高,且引起肠PMASD的危险因素众多,提醒医护人员应针对危险因素进行早期干预,以减轻不良结局对患者的影响。
Objective To systematically evaluate the incidence and risk factors for peristomal moisture-associated skin damage(PMASD).Methods Databases including CNKI,Wanfang,VIP,EMbase,PubMed,Web of Science,and Cochrane Library were searched for studies on the incidence and influencing factors of PMASD in patients with enterostomy,with a retrieval period up to October 2023.The included studies were analyzed using Stata software for meta-analysis.Results Eleven studies involving 3222 patients were included.The incidence of PMASD was 41%[95%confidence interval(95%CI)0.30-0.51].A total of 22 risk factors were identified,with 16 being combinable.Age[odds ratio(OR)=1.06,95%CI 1.03-1.09],gender(OR=1.38,95%CI 1.04-1.84),education level(OR=4.17,95%CI 2.27-7.68),patient history of radiotherapy(OR=5.42,95%CI 3.89-7.56),diabetes(OR=3.80,95%CI 1.03-1.09),type of stoma(OR=3.14,95%CI 2.20-4.48),type of ostomy pouch worn(OR=4.46,95%CI 1.95-10.20),stoma complications(OR=1.98,95%CI 2.81-3.17),patient self-care ability for stoma(OR=2.65,95%CI 3.41-6.36),stoma height(OR=1.42,95%CI 1.30-1.94),wound in the pouch base area(OR=4.97,95%CI 3.50-7.06),pouch leakage>3 times(OR=2.97,95%CI 1.59-5.54),surgical approach(OR=2.12,95%CI 1.51-2.97),and weight gain or loss less than 5 kg(OR=1.29,95%CI 1.17-1.42)were all associated with the occurrence of PMASD.Conclusion Existing evidence suggests that the incidence of PMASD is high and there are numerous risk factors contributing to it.Medical staff should conduct early interventions targeting these risk factors to mitigate the impact of adverse outcomes on patients.
作者
谢若男
王国蓉
冷英杰
蒋欣
李成香
聂茁苗
XIE Ruonan;WANG Guorong;LENG Yingjie;JIANG Xin;LI Chengxiang;NIE Zhuomiao(School of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610075,China;West China School of Public Health,Sichuan University/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China)
出处
《现代医药卫生》
2024年第23期4086-4091,共6页
Journal of Modern Medicine & Health
