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目的分析重症脑卒中患者并发失禁相关性皮炎(IAD)的影响因素,为IAD防治提供依据。方法收集125例重症脑卒中患者临床资料,根据住院期间患者有无IAD,分为IAD组和非IAD组,分析患者的性别、年龄、昏迷、体温、BMI、合并慢性病、神经功能(NIHSS)评分、卒中类型、营养和免疫等因素与并发IAD的关联性。结果 125例重症脑卒中患者中,30例并发IAD,占24.00%。其中轻度20例,中度7例,重度3例。多因素Logistic回归分析显示,年龄≥60岁(OR=7.515,95%CI:2.369~21.454)、体温≥38℃(OR=5.225,95%CI:2.612~10.774)、NIHSS评分≥12分(OR=3.467,95%CI:1.455~7.767)、出血性脑卒中(OR=0.596,95%CI:0.387~0.895)、低蛋白血症(OR=8.120,95%CI:3.574~27.644)是IAD发生的影响因素。结论高龄、发热≥38℃、NIHSS评分≥12分、缺血性脑卒中、低蛋白血症可能是重症脑卒中患者并发IAD的危险因素,应采取针对性的干预措施预防IAD发生。
Objective To analyze the influential factors of incontinence-associated dermatitis (IAD) in severe stroke patients and provide the basis for prevention and treatment of IAD. Methods The clinical data of 125 patients with severe stroke were collected. The patients were divided into IAD group and non-IAD group according to presence or absence of IAD during hospitalization. Gender, age, coma, body temperature, BMI, chronic obstructive pulmonary disease, NIHSS score , Stroke type, nutrition and immune and other factors associated with concurrent IAD. Results Among 125 patients with severe stroke, 30 patients had IAD, accounting for 24.00%. Of which mild in 20 cases, moderate in 7 cases, severe in 3 cases. Multivariate logistic regression analysis showed that the mean age at the age of 60 years or older was significantly higher than that of the normal subjects (OR = 7.515,95% CI: 2.369-21.454), body temperature ≥38 ℃ (OR = 5.225,95% CI 2.612-10.774) = 3.467, 95% CI: 1.455-7.767), hemorrhagic stroke (OR = 0.596, 95% CI: 0.387-0.895), hypoproteinemia (OR = 8.120, 95% CI: 3.574-27.644) The impact of factors. Conclusion In elderly patients, fever ≥38 ℃, NIHSS score ≥12, ischemic stroke and hypoalbuminemia may be risk factors for IAD in patients with severe stroke. Targeted interventions should be taken to prevent IAD.