目的

探讨标准化管理流程在防治重症监护病房（ICU）脑卒中患者失禁相关性皮炎（IAD）中的应用效果。

方法

选择2022 年5 月至2023 年12 月首都医科大学附属北京天坛医院ICU收治的100 例脑卒中二便失禁患者作为研究对象，根据患者入院时间的先后顺序分为对照组（50 例）及干预组（50 例）。对照组进行常规护理，干预组在对照组常规护理的基础上给予标准化的皮肤管理流程。收集2组患者IAD 发生率、发生时间、严重程度、治疗费用和患者家属满意度等资料，采用独立样本t 检验比较2组患者IAD 严重程度评分、发生时间、治疗费用、满意度评分的差异，采用χ² 检验比较2组IAD 发生率的差异。

结果

与对照组比较，干预组IAD 发生率低（4.00% vs 18.00%），发生时间延迟［（12.23±1.32）d vs（8.63±1.85）d］，严重程度评分低［（15.85±4.24）分 vs（25.43±4.63）分］，治疗费用低［（4342.53±2687.62）元 vs（5619.31±3426.27）元］，患者家属满意度评分高［（22.07±2.35）分 vs（16.84±2.44）分］，差异具有统计学意义（χ²=5.010，P=0.025；t=27.184，P＜0.001；t=33.543，P＜0.001；t=15.035，P＜0.001；t=4.845，P=0.026）。

结论

对脑卒中失禁患者实施标准化皮肤管理可有效降低IAD 的发生率和严重程度，延迟发生时间，降低治疗费用，提高患者家属的满意度。

Objective

To assess the impact of standardized management protocols on the prevention and treatment of incontinence associated dermatitis （IAD） in intensive care units （ICU）

Methods

A total of 100 stroke patients with incontinence admitted to the ICU of Beijing Tiantan Hospital， affiliated to Capital Medical University， from May 2022 to December 2023， were enrolled in this study. They were divided into the control group （50 cases） and the intervention group （50 cases） according to the order of admission time. The control group received routine care， whereas the intervention group underwent standardized skin management procedures on the basis of routine care in the control group. Data collected include the IAD incidence， onset time， severity， treatment cost， and patient family satisfaction for two groups of patients.The independent sample t-test was utilized to compare the differences in IAD severity score， occurrence time， treatment cost， and satisfaction score between the two groups. The chi-square test was employed to compare the differences in IAD incidence between the two groups.

Results

Compared with the control group， the intervention group had a lower incidence of IAD （4.00% vs 18.00%）， a delayed onset time［（12.23±1.32）d vs （8.63±1.85）d］， lower severity score ［（15.85±4.24） points vs （25.43±4.63） points］，reduced treatment costs ［（4342.53±2687.62） yuan vs （5619.31±3426.27） yuan］， and higher patient family satisfaction scores ［（22.07±2.35） points vs （16.84±2.44） points］， with statistically significant differences（χ²=5.010）， P=0.025； t=27.184， P＜0.001； t=33.543， P＜0.001； t=15.035， P＜0.001； t=4.845， P=0.026）.

Conclusion

The implementation of standardized management protocols in stroke patients with incontinence admitted to the ICU can effectively reduce the incidence and severity of IAD， delay its onset， lower treatment costs， and improve patient family satisfaction.