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饮食类型对造口周围潮湿相关性皮肤损伤的影响 |
刘莺歌1, 吴燕1, 曹秋君1, 邱群2, 吕桂芬2, 卜丽文3, 顾佳妮4
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1.复旦大学附属中山医院护理部, 上海 200032;2.海军军医大学第一附属医院肛肠外科, 上海 200433;3.复旦大学附属肿瘤医院护理部, 上海 200032;4.上海交通大学医学院附属新华医院急诊外科, 上海 200092
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摘要: |
目的:探讨饮食类型对造口周围潮湿相关性皮肤损伤(peristomal moisture-associated skin damage,PMASD)的影响。方法:采用方便抽样法选取2019年11月至2020年9月复旦大学附属中山医院、复旦大学附属肿瘤医院、海军军医大学第一附属医院和上海交通大学医学院附属新华医院收治的行肠造口术患者362例。根据患者饮食类型分为普食、软食、半流质、流质4组,定期随访所有患者至术后3个月。采用统一的PMASD评定表和肠造口患者调查表收集结局变量和其他预测变量资料,采用R软件的logistic逐步回归法分析饮食类型对PMASD的预测效能并纳入其他预测变量进行校正。结果:共329例患者完成随访,发生PMASD 141例(42.8%),其中普食组37例(26.2%)、软食组48例(34.1%)、半流质组56例(39.7%)。软食及半流质在校正前后均为独立预测因子,校正后OR值分别为6.30(95% CI 3.31~12.32,P<0.001)和8.99(95% CI 4.47~18.81,P<0.001),模型校正前后的拟合效果均良好,AUC分别为0.767(95% CI 0.718~0.815)和0.845(95% CI 0.804~0.886)。结论:饮食类型是造口周围潮湿相关性皮肤损伤的重要影响因素;与普食相比,软食和半流质会增加PMASD风险且半流质风险高于软食。 |
关键词: 肠造口 造口周围潮湿相关性皮肤损伤 饮食 预测 |
DOI:10.12025/j.issn.1008-6358.2021.20210083 |
分类号:R459.3 |
基金项目:复旦大学-复星护理科研基金(FNF201942),复旦大学附属中山医院青年基金(2019ZSQN09). |
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The predictive value of diet in peristomal moisture associated skin damage |
LIU Ying-ge1, WU Yan1, CAO Qiu-jun1, QIU Qun2, Lü Gui-fen2, BU Li-wen3, GU Jia-ni4
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1.Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai 200032, China;2.Department of Anorectal Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China;3.Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai 200032, China;4.Department of Emergency Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Abstract: |
Objective: To explore the predictive value of diet in peristomal moisture-associated skin damage. Methods: From November 2019 to September 2020, 362 patients with enterostomy were selected from Zhongshan Hospital, Fudan University, Fudan University Shanghai Cancer center, The First Affiliated Hospital of Naval Medical University and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medical. All patients were followed up for 3 months. The diet types of patients were judged by general diet, soft diet, semi-liquid diet and liquid diet. The unified assessment guidance of PMASD was used to diagnose the outcome. Logistic stepwise regression was used to explore the predictive effect of diet on the risk of PMASD, and other predictors were included for correction. Results: Among the 329 patients who completed the 3-month follow-up, 141 (42.8%) had PMASD, among which 37 (26.2%) had general diet, 48 (34.1%) had soft diet and 56 (39.7%) had semi-liquid diet. Soft and semi-fluid diet were independent risk predictors of PMASD both before and after adjustment. The adjusted OR were 6.30 (95%CI 3.31-12.32, P<0.001) and 8.99 (95%CI 4.47-18.81, P<0.001) respectively. The AUC was 0.767 (95%CI 0.718-0.815) and 0.845 (95%CI 0.804-0.886) respectively. Conclusions: Dietary types can be used to predict the risk of PMASD. Compared with regular diet, soft diet and semi-liquid diet increased the risk of complications, and the risk of semi-liquid diet was higher than that of soft diet. |
Key words: ostomy peristomal moisture-associated skin damage diet prediction |