ICU Nursing Knowledge: Nursing Experience of Perianal Fungal Infection in ICU Patients

The patients admitted to intensive care unit (ICU) are seriously ill, most of whom are bedridden for a long time with incontinence, and are prone to perianal fungal infection. This article is the observation and nursing of 12 cases. The report is as follows.

1 Clinical data

There were 12 cases in the whole group, including 1 males and 2 females, aged from 49 to 78 years, with an average of (68 7.5) years. The primary diseases were cerebral thrombosis paraplegia in 5 cases, cerebral hemorrhage to hemiplegia in 2 cases, viral meningitis in 2 cases, purulent meningitis in 1 case, abdominal aortic aneurysm in 1 case, and liver coma in 1 case after liver cancer. Among them, 5 cases of perianal fungal infection were brought into ICU when they were admitted to hospital, 3 cases were brought into ICU from the original ward, and 4 cases occurred in ICU. Among the 12 cases, 5 cases of rash scraping samples were cultured with fungi, and fungi were found to grow. 12 cases were treated by external application of Dyclonine powder for about 1 week, 1 cases were cured and 2 cases were improved.

2 introduction of typical cases

A 66-year-old male patient was admitted to the Department of Neurology because of sudden aphasia and limb weakness for 4 hours, and was transferred to ICU for monitoring due to the deterioration of his condition. Physical examination: conscious, motor aphasia, limb weakness, incontinence, skin rash around perineum, penis, scrotum and anus, and even ulceration and exudation of a small part of skin. Take a rash and scrape it to cultivate mold. After 1 week of treatment with Dyclonine powder, edema subsided, eczema improved, exudation disappeared and skin was dry. The condition was stable and transferred back to the original ward, and he recovered after 1 week of follow-up.

3 Experience

Treatment and nursing measures: (1) Keep local skin clean, thoroughly clean perineum and perianal skin with warm water after defecation, and prohibit toilet paper (because toilet paper can increase friction). After cleaning, it is irradiated by spectrometer for 3 minutes, and then it is coated with Dyclonine powder. (2) Turn over once every 2 hours. When lying on your back, try to let go of your thighs to expose scrotum and groin to reduce friction. (3) Take Changtai, Zhengchangsheng and Yimengting orally, so as to reduce the frequency of defecation, and indwelling catheter to receive urine bag to reduce irritation. (4) Do a good job in diet care: give a high-protein, high-vitamin and high-calorie diet. Those who can't eat, stay in the stomach tube for nasal feeding, and eat a small amount. Provide enough high-quality protein, vitamins and trace elements for the repair of local ulcerated tissues. Use laxatives such as rhubarb as little as possible < P > Perianal eczema is caused by local skin being stimulated by alkaline intestinal juice for a long time or complicated with fungal infection, which causes skin redness and even ulceration. Traditional nursing care of perianal eczema is externally applied with common talcum powder, and the general cure time takes 2 weeks or more. Because talcum powder only plays the role of keeping the skin dry and smooth, while dakening powder not only has the role of talcum powder, but also has the role of anti-mold. The cure time is only about 1 week.

Spectrometer irradiation also plays a good auxiliary role in the treatment or prevention of perianal fungal infection. After spectrum irradiation, it can promote the whole metabolism of the body, improve the activity of enzymes, enhance the immunity of the body, improve the local blood circulation, reduce exudation, make the local dry, and have the effect of preventing infection.