新型冠状病毒肺炎疫情防控下一线医护人员皮肤损伤的预防护理策略

Prevention and Nursing Strategy of Skin Injury of Front-Line Medical Staff under the Prevention and Treatment of SARS-COVID-19

摘要: 目的：探讨新型冠状病毒肺炎疫情防控下防护装备所致一线医务人员皮肤损伤的现况分析，并制定规范预防护理策略。方法：2022年5月~10月，横断面多中心研究调查参加一线抗疫工作的816名医护人员为研究对象。由本课题组研制的调研问卷，采用手机端电子问卷或纸质版问卷进行调查，重点询问有无皮肤皲裂、过敏性皮炎、压力性损伤等方面，建立调查数据库，分析不同因素下皮肤损伤的发生率、损伤类型及表现特点；及时推送相关皮肤护理知识，跟踪随访评估对策的有效性。结果：共回收有效问卷816份，有321人发生皮肤损伤，皮肤损伤发生率为39.34%。其中，潮湿相关性皮肤损伤(MASD)发生率为18.38%，压力性损伤(DRPI)发生率为19.24%，皮肤撕裂伤(ST)发生率为1.72%。医护人员穿戴一、二、三级防护装备皮肤损伤发生率分别为18.81%、70.00%和79.12%，差异有统计学意义(P < 0.05)。在不同的损伤类型中，皮肤损伤部位前三位是鼻部(30.53%)、面颊(28.21%)、额部(24.36%)，占总损伤率的81.62%。不同年龄、工作岗位、穿戴防护装备时间、皮肤防护频次、岗前培训等整体情况，医护人员皮肤损伤发生率有明显的差异(均P < 0.05)。医护人员整体对皮肤护理措施认知度评分较低，早期岗前培训是皮肤损伤的保护因素。结论：防护装备所致一线医务人员皮肤损伤的发生率较高，组织管理层面进行必要的岗前培训值得重视，我们制定的局部减压、护肤等针对性皮肤防护策略，可有效减少皮肤损伤的风险，提高皮肤舒适度。

Abstract: Objective: To investigate the current situation of skin injuries caused by protective equipment in front-line medical staff under the prevention of SARS-COVID-19, and to formulate standardized preventive nursing strategies. Methods: From May to October 2022, a cross-sectional multicenter study was conducted to investigate 816 doctors and nurses who participated in the first-line anti epidemic work. The survey questionnaire developed by our research group adopts the mobile phone terminal electronic questionnaire or the paper version questionnaire to conduct the survey, focusing on whether there are skin chaps, allergic dermatitis, stress injuries, etc., establishing a survey database, and analyzing the incidence, types and characteristics of skin injuries under dif-ferent factors; timely push relevant skin care knowledge, and track the effectiveness of measures. Results: A total of 816 valid questionnaires were collected, 321 people had skin injuries, and the in-cidence of skin injuries was 39.34%. Among them, the incidence of moisture related skin injury (MASD) was 18.38%, the incidence of pressure injury (DRPI) was 19.24%, and the incidence of skin laceration (ST) was 1.72%. The incidence of skin injury of medical staff wearing Class I, II and III protective equipment was 18.81%, 70.00% and 79.12% respectively, with a statistically significant difference (P < 0.05). In different injury types, the top three skin injury sites were nose (30.53%), cheek (28.21%) and forehead (24.36%). There was a significant difference in the incidence of skin injury among medical staff in different posts, wearing time of protective equipment, pre job training and other overall conditions (all P < 0.05). The overall recognition score of the medical staff on skin care measures is low, and early pre job training is a protective factor for skin damage. Conclusion: The incidence of skin injury of front-line medical personnel caused by protective equipment is high. It is worth paying attention to the necessary pre job training at the organizational and management level. The targeted skin protection strategies we have formulated, such as local decompression and skin care, can effectively reduce the risk of skin injury and improve skin comfort.