重症监护病房新生儿皮肤管理指南（2021）

doi:10.7499/j.issn.1008-8830.2106004

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中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (7) : 659-670. DOI: 10.7499/j.issn.1008-8830.2106004

标准·方案·指南

重症监护病房新生儿皮肤管理指南（2021）

中国医师协会新生儿科医师分会循证专业委员会

作者信息 +

Guidelines for neonatal skin management in the neonatal intensive care unit (2021)

Evidence-Based Medicine Group, Neonatologist Society, Chinese Medical Doctor Association

Author information +

文章历史 +

摘要

新生儿皮肤屏障功能弱，极易受损而导致局部或全身感染，增加死亡风险。保护新生儿皮肤完整性、预防皮肤损伤是新生儿重症监护病房管理的重要内容之一。该指南基于国内外相关证据，采用证据推荐分级的评估、制定与评价方法进行证据分级，制定新生儿重症监护病房新生儿皮肤管理指南，对皮肤常规管理、医源性皮肤损伤的预防及处理给出推荐意见，旨在帮助医护人员为新生儿提供预防及处理皮肤损伤的参考建议。

Abstract

Neonates are easily suffering from local or systematic infections due to their vulnerable skin barrier function, which leads to the increasing risk of death. Therefore, it is important to protect neonatal skin integrity and prevent neonatal skin injury in the neonatal intensive care unit (NICU). Based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and current evidence, the guidelines for neonatal skin management in the NICU were developed to provide recommendations on routine skin care and prevention and treatment of iatrogenic skin injury of neonates for health care providers.

导出引用

中国医师协会新生儿科医师分会循证专业委员会. 重症监护病房新生儿皮肤管理指南（2021）[J]. 中国当代儿科杂志. 2021, 23(7): 659-670 https://doi.org/10.7499/j.issn.1008-8830.2106004

Evidence-Based Medicine Group, Neonatologist Society, Chinese Medical Doctor Association. Guidelines for neonatal skin management in the neonatal intensive care unit (2021)[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(7): 659-670 https://doi.org/10.7499/j.issn.1008-8830.2106004

参考文献

[1] Afsar FS. Physiological skin conditions of preterm and term neonates[J]. Clin Exp Dermatol, 2010, 35(4):346-350. DOI:10.1111/j.1365-2230.2009.03562.x. PMID:19758381.
[2] Fluhr JW, Darlenski R, Taieb A, et al. Functional skin adaptation in infancy-almost complete but not fully competent[J]. Exp Dermatol, 2010, 19(6):483-492. DOI:10.1111/j.1600-0625.2009.01023.x. PMID:20353516.
[3] 杨童玲, 胡晓静, 吕天婵. NICU患儿医源性皮肤损伤的现况调查[J]. 中华护理杂志, 2019, 54(9):1369-1372. DOI:10.3761/j.issn.0254-1769.2019.09.017.
[4] Csoma ZR, Meszes A, Ábrahám R, et al. Iatrogenic skin disorders and related factors in newborn infants[J]. Pediatr Dermatol, 2016, 33(5):543-548. DOI:10.1111/pde.12960. PMID:27595870.
[5] Kugelman A, Inbar-Sanado E, Shinwell ES, et al. Iatrogenesis in neonatal intensive care units:observational and interventional, prospective, multicenter study[J]. Pediatrics, 2008, 122(3):550-555. DOI:10.1542/peds.2007-2729. PMID:18762525.
[6] Guyatt GH, Oxman AD, Schünemann HJ, et al. GRADE guidelines:a new series of articles in the Journal of Clinical Epidemiology[J]. J Clin Epidemiol, 2011, 64(4):380-382. DOI:10.1016/j.jclinepi.2010.09.011. PMID:21185693.
[7] World Health Organization. WHO recommendations on postnatal care of the mother and newborn[EB/OL].[2020-12-28]. https://apps.who.int/iris/bitstream/handle/10665/97603/9789241506649_eng.pdf.
[8] Brandon D, Hill CM, Heimall L, et al. Neonatal skin care:evidence-based clinical practice guideline[M]. 4th ed. Washington DC:Association of Women's Health, Obstetric and Neonatal Nurses, 2018.
[9] Colwell A. To bathe or not to bathe:the neonatal question[J]. Neonatal Netw, 2015, 34(4):216-219. DOI:10.1891/0730-0832.34.4.216. PMID:26802635.
[10] Kuller JM. Update on newborn bathing[J]. Newborn Infant Nurs Rev, 2014, 14(4):166-170. DOI:10.1053/j.nainr.2014.10.006.
[11] Lawn JE, Davidge R, Paul VK, et al. Born too soon:care for the preterm baby[J]. Reprod Health, 2013, 10(Suppl 1):S5. DOI:10.1186/1742-4755-10-S1-S5. PMID:24625233. PMCID:PMC3828583.
[12] Loring C, Gregory K, Gargan B, et al. Tub bathing improves thermoregulation of the late preterm infant[J]. J Obstet Gynecol Neonatal Nurs, 2012, 41(2):171-179. DOI:10.1111/j.1552-6909.2011.01332.x. PMID:22375955.
[13] Ta?demir H?, Efe E. The effect of tub bathing and sponge bathing on neonatal comfort and physiological parameters in late preterm infants:a randomized controlled trial[J]. Int J Nurs Stud, 2019, 99:103377. DOI:10.1016/j.ijnurstu.2019.06.008. PMID:31442786.
[14] Ceylan SS, BolL?Lk B. Effects of swaddled and sponge bathing methods on signs of stress and pain in premature newborns:implications for evidence-based practice[J]. Worldviews Evid Based Nurs, 2018, 15(4):296-303. DOI:10.1111/wvn.12299. PMID:29763976.
[15] Edraki M, Paran M, Montaseri S, et al. Comparing the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants:a randomized clinical trial[J]. J Caring Sci, 2014, 3(2):83-91. DOI:10.5681/jcs.2014.009. PMID:25276751. PMCID:PMC4134173.
[16] Çaka SY, Gözen D. Effects of swaddled and traditional tub bathing methods on crying and physiological responses of newborns[J]. J Spec Pediatr Nurs, 2018, 23(1):e12202. DOI:10.1111/jspn.12202. PMID:29160925.
[17] 徐仁凤, 曹洁, 郑文婷, 等. 襁褓式沐浴与盆浴两种方式对新生儿行为状态的影响[J]. 中国实用护理杂志, 2018, 34(27):2138-2141. DOI:10.3760/cma.j.issn.1672-7088.2018.27.012.
[18] Finn M, Meyer A, Kirsten D, et al. Swaddled bathing in the neonatal intensive care unit[J]. Neoreviews, 2017, 18(8):e504-e506. DOI:10.1542/neo.18-8-e504.
[19] Fernández D, Antolín-Rodríguez R. Bathing a premature infant in the intensive care unit:a systematic review[J]. J Pediatr Nurs, 2018, 42:e52-e57. DOI:10.1016/j.pedn.2018.05.002. PMID:29779763.
[20] Heimall LM, Storey B, Stellar JJ, et al. Beginning at the bottom:evidence-based care of diaper dermatitis[J]. MCN Am J Matern Child Nurs, 2012, 37(1):10-16. DOI:10.1097/NMC.0b013e31823850ea. PMID:22072018.
[21] Visscher M, Odio M, Taylor T, et al. Skin care in the NICU patient:effects of wipes versus cloth and water on stratum corneum integrity[J]. Neonatology, 2009, 96(4):226-234. DOI:10.1159/000215593. PMID:19407468.
[22] Rowe J, McCall E, Kent B. Clinical effectiveness of barrier preparations in the prevention and treatment of nappy dermatitis in infants and preschool children of nappy age[J]. Int J Evid Based Healthc, 2008, 6(1):3-23. DOI:10.1111/j.1744-1609.2007.00095.x. PMID:21631812.
[23] Klunk C, Domingues E, Wiss K. An update on diaper dermatitis[J]. Clin Dermatol, 2014, 32(4):477-487. DOI:10.1016/j.clindermatol.2014.02.003. PMID:25017459.
[24] 舒德喜, 周军, 罗小冬. 5%鞣酸软膏治疗新生儿"红臀"的临床观察[J]. 中国妇幼保健, 2009, 24(12):1725.
[25] 张凤琴, 宛翠秀, 张凤. 自制鞣酸软膏预防新生儿红臀的临床观察[J]. 安徽医药, 2009, 13(11):1400. DOI:10.3969/j.issn.1009-6469.2009.11.047.
[26] Merrill L. Prevention, treatment and parent education for diaper dermatitis[J]. Nurs Womens Health, 2015, 19(4):324-336; quiz 337. DOI:10.1111/1751-486X.12218. PMID:26264797.
[27] 刘慧. 红霉素锌氧油联合暴露疗法治疗新生儿重Ⅱ度红臀的效果观察[J]. 当代护士(中旬刊), 2019, 26(3):84-85.
[28] Gupta AK, Skinner AR. Management of diaper dermatitis[J]. Int J Dermatol, 2004, 43(11):830-834. DOI:10.1111/j.1365-4632.2004.02405.x. PMID:15533067.
[29] Stamatas GN, Tierney NK. Diaper dermatitis:etiology, manifestations, prevention, and management[J]. Pediatr Dermatol, 2014, 31(1):1-7. DOI:10.1111/pde.12245. PMID:24224482.
[30] Wolf R, Wolf D, Tüzün B, et al. Diaper dermatitis[J]. Clin Dermatol, 2000, 18(6):657-660. DOI:10.1016/s0738-081x(00)00157-7. PMID:11173200.
[31] Ness MJ, Davis DM, Carey WA. Neonatal skin care:a concise review[J]. Int J Dermatol, 2013, 52(1):14-22. DOI:10.1111/j.1365-4632.2012.05687.x. PMID:23278604.
[32] 张琳琪, 李杨, 宋楠, 等. 婴幼儿尿布性皮炎护理实践专家共识[J]. 中华护理杂志, 2020, 55(8):1169. DOI:10.3761/j.issn.0254-1769.2020.08.008.
[33] World Health Organization. Care of the umbilical cord:a review of the evidence[EB/OL].[2020-12-28]. http://bvsper.paho.org/videosdigitales/matedu/ICATT-AIEPI/Data/Care%20of%20the%20umbilical%20cord/fd38a9b4-bfa1-4735-9a9a-e7dbb0faa720.pdf.
[34] Stewart D, Benitz W, Committee on Fetus and Newborn. Umbilical cord care in the newborn infant[J]. Pediatrics, 2016, 138(3):e20162149. DOI:10.1542/peds.2016-2149. PMID:27573092.
[35] Zupan J, Garner P, Omari AA. Topical umbilical cord care at birth[J]. Cochrane Database Syst Rev, 2004, 2004(3):CD001057. DOI:10.1002/14651858.CD001057.pub2. PMID:15266437. PMCID:PMC6457922.
[36] Sankar MJ, Chandrasekaran A, Ravindranath A, et al. Umbilical cord cleansing with chlorhexidine in neonates:a systematic review[J]. J Perinatol, 2016, 36(Suppl 1):S12-S20. DOI:10.1038/jp.2016.28. PMID:27109088. PMCID:PMC4848738.
[37] Imdad A, Bautista RM, Senen KA, et al. Umbilical cord antiseptics for preventing sepsis and death among newborns[J]. Cochrane Database Syst Rev, 2013(5):CD008635. DOI:10.1002/14651858.CD008635.pub2. PMID:23728678.
[38] 中华医学会围产医学分会, 中华医学会妇产科学分会产科学组, 中华护理学会产科护理专业委员会, 等. 中国新生儿早期基本保健技术专家共识(2020)[J]. 中华围产医学杂志, 2020, 23(7):433-440. DOI:10.3760/cma.j.cn113903-20200416-00354.
[39] Alkharfy T, Ba-Abbad R, Hadi A, et al. Use of topical petroleum jelly for prevention of sepsis in very low-birthweight infants:a prospective, randomised controlled trial[J]. Paediatr Int Child Health, 2014, 34(3):194-197. DOI:10.1179/2046905514Y.0000000117. PMID:24593664.
[40] Darmstadt GL, Badrawi N, Law PA, et al. Topically applied sunflower seed oil prevents invasive bacterial infections in preterm infants in Egypt:a randomized, controlled clinical trial[J]. Pediatr Infect Dis J, 2004, 23(8):719-725. DOI:10.1097/01.inf.0000133047.50836.6f. PMID:15295221.
[41] Kiechl-Kohlendorfer U, Berger C, Inzinger R. The effect of daily treatment with an olive oil/lanolin emollient on skin integrity in preterm infants:a randomized controlled trial[J]. Pediatr Dermatol, 2008, 25(2):174-178. DOI:10.1111/j.1525-1470.2008.00627.x. PMID:18429773.
[42] Salam RA, Darmstadt GL, Bhutta ZA. Effect of emollient therapy on clinical outcomes in preterm neonates in pakistan:a randomised controlled trial[J]. Arch Dis Child Fetal Neonatal Ed, 2015, 100(3):F210-F215. DOI:10.1136/archdischild-2014-307157. PMID:25637007.
[43] Cleminson J, McGuire W. Topical emollient for preventing infection in preterm infants[J]. Cochrane Database Syst Rev, 2016, 2016(1):CD001150. DOI:10.1002/14651858.CD001150.pub3. PMID:26824786. PMCID:PMC7027999.
[44] National Association of Neonatal Nurses. Peripherally inserted central catheters:guideline for practice, 3rd edition[EB/OL].[2020-07-16]. http://hummingbirdmed.com/wp-content/uploads/NANN15_PICC_Guidelines_FINAL.pdf.
[45] Aitken J, Williams FL. A systematic review of thyroid dysfunction in preterm neonates exposed to topical iodine[J]. Arch Dis Child Fetal Neonatal Ed, 2014, 99(1):F21-F28. DOI:10.1136/archdischild-2013-303799. PMID:24105624.
[46] Lund CH, Osborne JW, Kuller J, et al. Neonatal skin care:clinical outcomes of the AWHONN/NANN evidence-based clinical practice guideline. Association of Women's Health, Obstetric and Neonatal Nurses and the National Association of Neonatal Nurses[J]. J Obstet Gynecol Neonatal Nurs, 2001, 30(1):41-51. DOI:10.1111/j.1552-6909.2001.tb01520.x. PMID:11277161.
[47] 中国医师协会新生儿科医师分会循证专业委员会. 新生儿经外周置入中心静脉导管操作及管理指南(2021)[J]. 中国当代儿科杂志, 2021, 23(3):201-212. DOI:10.7499/j.issn.1008-8830.2101087. PMID:33691911. PMCID:PMC7969181.
[48] Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals:2014 update[J]. Infect Control Hosp Epidemiol, 2014, 35(7):753-771. DOI:10.1086/676533. PMID:24915204.
[49] Beresford D. MHRA report chlorhexidine solutions:risk of chemical burn injury to skin in premature infants[J]. J Neonatal Nurs, 2015, 21(2):47-49. DOI:10.1016/j.jnn.2015.02.002.
[50] Huang EY, Chen C, Abdullah F, et al. Strategies for the prevention of central venous catheter infections:an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review[J]. J Pediatr Surg, 2011, 46(10):2000-2011. DOI:10.1016/j.jpedsurg.2011.06.017. PMID:22008341.
[51] 中华人民共和国国家卫生和计划生育委员会. 静脉治疗护理技术操作规范:WS/T 433-2013[S]. 北京:中国标准出版社, 2014.
[52] Bringué Espuny X, Soria X, Solé E, et al. Chlorhexidine-methanol burns in two extreme preterm newborns[J]. Pediatr Dermatol, 2010, 27(6):676-678. DOI:10.1111/j.1525-1470.2010.01178.x. PMID:21510025.
[53] Lashkari HP, Chow P, Godambe S. Aqueous 2% chlorhexidine-induced chemical burns in an extremely premature infant[J]. Arch Dis Child Fetal Neonatal Ed, 2012, 97(1):F64. DOI:10.1136/adc.2011.215145. PMID:21746795.
[54] Mannan K, Chow P, Lissauer T, et al. Mistaken identity of skin cleansing solution leading to extensive chemical burns in an extremely preterm infant[J]. Acta Paediatr, 2007, 96(10):1536-1537. DOI:10.1111/j.1651-2227.2007.00376.x. PMID:17727692.
[55] Neri I, Ravaioli GM, Faldella G, et al. Chlorhexidine-induced chemical burns in very low birth weight infants[J]. J Pediatr, 2017, 191:262-265.e2. DOI:10.1016/j.jpeds.2017.08.002. PMID:29173315.
[56] Vanzi V, Pitaro R. Skin injuries and chlorhexidine gluconate-based antisepsis in early premature infants:a case report and review of the literature[J]. J Perinat Neonatal Nurs, 2018, 32(4):341-350. DOI:10.1097/JPN.0000000000000334. PMID:29782437.
[57] Kutsch J, Ottinger D. Neonatal skin and chlorhexidine:a burning experience[J]. Neonatal Netw, 2014, 33(1):19-23. DOI:10.1891/0730-0832.33.1.19. PMID:24413032.
[58] Reynolds PR, Banerjee S, Meek JH. Alcohol burns in extremely low birthweight infants:still occurring[J]. Arch Dis Child Fetal Neonatal Ed, 2005, 90(1):F10. DOI:10.1136/adc.2004.054338. PMID:15613563. PMCID:PMC1721832.
[59] McCord H, Fieldhouse E, El-Naggar W. Current practices of antiseptic use in Canadian neonatal intensive care units[J]. Am J Perinatol, 2019, 36(2):141-147. DOI:10.1055/s-0038-1661406. PMID:29945280.
[60] Upadhyayula S, Kambalapalli M, Harrison CJ. Safety of anti-infective agents for skin preparation in premature infants[J]. Arch Dis Child, 2007, 92(7):646-647. DOI:10.1136/adc.2007.117002. PMID:17588981. PMCID:PMC2083764.
[61] McNichol L, Lund C, Rosen T, et al. Medical adhesives and patient safety:state of the science:consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries[J]. Orthop Nurs, 2013, 32(5):267-281. DOI:10.1097/NOR.0b013e3182a39caf. PMID:24022422.
[62] Fumarola S, Allaway R, Callaghan R, et al. Overlooked and underestimated:medical adhesive-related skin injuries[J]. J Wound Care, 2020, 29(Sup3c):S1-S24. DOI:10.12968/jowc.2020.29.Sup3c.S1. PMID:32134695.
[63] Campbell K, Woodbury MG, Whittle H, et al. A clinical evaluation of 3M no sting barrier film[J]. Ostomy Wound Manage, 2000, 46(1):24-30. PMID:10732633.
[64] Shannon RJ, Chakravarthy D. Effect of a water-based no-sting, protective barrier formulation and a solvent-containing similar formulation on skin protection from medical adhesive trauma[J]. Int Wound J, 2009, 6(1):82-88. DOI:10.1111/j.1742-481X.2008.00559.x. PMID:19291121.
[65] O?neil A, Schumacher B. Application of a pectin barrier for medical adhesive skin injury (epidermal stripping) in a premature infant[J]. J Wound Ostomy Continence Nurs, 2014, 41(3):219-221. DOI:10.1097/WON.0000000000000029. PMID:24805172.
[66] Denyer J. Reducing pain during the removal of adhesive and adherent products[J]. Br J Nurs, 2011, 20(15):S28, S30-S35. DOI:10.12968/bjon.2011.20.Sup8.S28. PMID:21841648.
[67] Barton A. Medical adhesive-related skin injuries associated with vascular access:minimising risk with Appeel Sterile[J]. Br J Nurs, 2020, 29(8):S20-S27. DOI:10.12968/bjon.2020.29.8.S20. PMID:32324453.
[68] Collier M. Minimising pain and medical adhesive related skin injuries in vulnerable patients[J]. Br J Nurs, 2019, 28(15):S26-S32. DOI:10.12968/bjon.2019.28.15.S26. PMID:31393764.
[69] LeBlanc K, Baranoski S, Skin Tear Consensus Panel Members. Skin tears:state of the science:consensus statements for the prevention, prediction, assessment, and treatment of skin tears^©[J]. Adv Skin Wound Care, 2011, 24(9 Suppl):2-15. DOI:10.1097/01.ASW.0000405316.99011.95. PMID:21876389.
[70] Fox MD. Wound care in the neonatal intensive care unit[J]. Neonatal Netw, 2011, 30(5):291-303. DOI:10.1891/0730-0832.30.5.291. PMID:21846624.
[71] Hasegawa M, Inoue Y, Kaneko S, et al. Wound, pressure ulcer and burn guidelines-1:guidelines for wounds in general, second edition[J]. J Dermatol, 2020, 47(8):807-833. DOI:10.1111/1346-8138.15401. PMID:32614097.
[72] Bolton L. Operational definition of moist wound healing[J]. J Wound Ostomy Continence Nurs, 2007, 34(1):23-29. DOI:10.1097/00152192-200701000-00003. PMID:17228202.
[73] European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries:clinical practice guideline[EB/OL].[2020-12-29]. https://internationalguideline.com/static/pdfs/Quick_Reference_Guide-10Mar2019.pdf.
[74] Günlemez A, Isken T, Gökalp AS, et al. Effect of Silicon gel sheeting in nasal injury associated with nasal CPAP in preterm infants[J]. Indian Pediatr, 2010, 47(3):265-267. DOI:10.1007/s13312-010-0047-9. PMID:19430064.
[75] Xie LH. Hydrocolloid dressing in preventing nasal trauma secondary to nasal continuous positive airway pressure in preterm infants[J]. World J Emerg Med, 2014, 5(3):218-222. DOI:10.5847/wjem.j.issn.1920-8642.2014.03.011. PMID:25225588. PMCID:PMC4163817.
[76] King BC, Gandhi BB, Jackson A, et al. Mask versus prongs for nasal continuous positive airway pressure in preterm infants:a systematic review and meta-analysis[J]. Neonatology, 2019, 116(2):100-114. DOI:10.1159/000496462. PMID:31163418.
[77] Razak A, Patel W. Nasal mask vs binasal prongs for nasal continuous positive airway pressure in preterm infants:a systematic review and meta-analysis[J]. Pediatr Pulmonol, 2020, 55(9):2261-2271. DOI:10.1002/ppul.24878. PMID:32478923.
[78] 李磊, 王自珍, 孔祥永, 等. 鼻塞鼻罩交替使用预防极低出生体重儿经鼻持续正压通气致鼻损伤的效果[J]. 中华新生儿科杂志(中英文), 2017, 32(2):131-133. DOI:10.3760/cma.j.issn.2096-2932.2017.02.013.
[79] 新生儿医源性皮肤损伤的评估要点和预见性护理的专家共识工作组, 海峡两岸医药卫生交流协会第一届新生儿专业委员会新生儿护理与护理管理学组. 新生儿医源性皮肤损伤的评估要点和预见性护理的专家共识[J]. 中国循证儿科杂志, 2020, 15(3):161-165. DOI:10.3969/j.issn.1673-5501.2020.03.001.
[80] Wound, Ostomy and Continence Nurses Society-Wound Guidelines Task Force. WOCN 2016 guideline for prevention and management of pressure injuries (ulcers):an executive summary[J]. J Wound Ostomy Continence Nurs, 2017, 44(3):241-246. DOI:10.1097/WON.0000000000000321. PMID:28472816.
[81] Ho CH, Bensitel T, Wang XF, et al. Pulsatile lavage for the enhancement of pressure ulcer healing:a randomized controlled trial[J]. Phys Ther, 2012, 92(1):38-48. DOI:10.2522/ptj.20100349. PMID:21949432.
[82] Fernandez R, Griffiths R. Water for wound cleansing[J]. Cochrane Database Syst Rev, 2012(2):CD003861. DOI:10.1002/14651858.CD003861.pub3. PMID:22336796.
[83] Fujiwara H, Isogai Z, Irisawa R, et al. Wound, pressure ulcer and burn guidelines-2:guidelines for the diagnosis and treatment of pressure ulcers, second edition[J]. J Dermatol, 2020, 47(9):929-978. DOI:10.1111/1346-8138.14587. PMID:30194884.
[84] Kim JT, Park JY, Lee HJ, et al. Guidelines for the management of extravasation[J]. J Educ Eval Health Prof, 2020, 17:21. DOI:10.3352/jeehp.2020.17.21. PMID:32668826. PMCID:PMC7431942.
[85] Wickham R, Engelking C, Sauerland C, et al. Vesicant extravasation part II:evidence-based management and continuing controversies[J]. Oncol Nurs Forum, 2006, 33(6):1143-1150. DOI:10.1188/06/ONF.1143-1150. PMID:17149397.
[86] Vandeweyer E, Deraemaecker R. Early surgical suction and washout for treatment of cytotoxic drug extravasations[J]. Acta Chir Belg, 2000, 100(1):37-38. PMID:10776527.
[87] Massand S, Carr L, Schneider E, et al. Management of intravenous infiltration injuries[J]. Ann Plast Surg, 2019, 83(6):e55-e58. DOI:10.1097/SAP.0000000000001984. PMID:31688099.
[88] Lawson SL, Brady W, Mahmoud A. Identification of highly concentrated dextrose solution (50% dextrose) extravasation and treatment-a clinical report[J]. Am J Emerg Med, 2013, 31(5):886.e3-886.e5. DOI:10.1016/j.ajem.2012.12.010. PMID:23602753.
[89] Yan YM, Fan QL, Li AQ, et al. Treatment of cutaneous injuries of neonates induced by drug extravasation with hyaluronidase and hirudoid[J]. Iran J Pediatr, 2014, 24(4):352-358. PMID:25755854. PMCID:PMC4339556.
[90] Sushko K, Litalien C, Ferruccio L, et al. Topical nitroglycerin ointment as salvage therapy for peripheral tissue ischemia in newborns:a systematic review[J]. CMAJ Open, 2021, 9(1):E252-E260. DOI:10.9778/cmajo.20200129. PMID:33731426. PMCID:PMC8096410.
[91] Wong AF, McCulloch LM, Sola A. Treatment of peripheral tissue ischemia with topical nitroglycerin ointment in neonates. Treatment of peripheral tissue ischemia with topical nitroglycerin ointment in neonates[J]. J Pediatr, 1992, 121(6):980-983. DOI:10.1016/s0022-3476(05)80356-7. PMID:1447671.
[92] Reynolds PM, Maclaren R, Mueller SW, et al. Management of extravasation injuries:a focused evaluation of noncytotoxic medications[J]. Pharmacotherapy, 2014, 34(6):617-632. DOI:10.1002/phar.1396. PMID:24420913.
[93] Gopalakrishnan PN, Goel N, Banerjee S. Saline irrigation for the management of skin extravasation injury in neonates[J]. Cochrane Database Syst Rev, 2017, 7(7):CD008404. DOI:10.1002/14651858.CD008404.pub3. PMID:28724193. PMCID:PMC6483149.
[94] Gault DT. Extravasation injuries[J]. Br J Plast Surg, 1993, 46(2):91-96. DOI:10.1016/0007-1226(93)90137-z. PMID:8461914.
[95] Wiegand R, Brown J. Hyaluronidase for the management of dextrose extravasation[J]. Am J Emerg Med, 2010, 28(2):257.e1-257.e2. DOI:10.1016/j.ajem.2009.06.010. PMID:20159411.
[96] Kostogloudis N, Demiri E, Tsimponis A, et al. Severe extravasation injuries in neonates:a report of 34 cases[J]. Pediatr Dermatol, 2015, 32(6):830-835. DOI:10.1111/pde.12664. PMID:26337780.
[97] Ghanem AM, Mansour A, Exton R, et al. Childhood extravasation injuries:improved outcome following the introduction of hospital-wide guidelines[J]. J Plast Reconstr Aesthet Surg, 2015, 68(4):505-518. DOI:10.1016/j.bjps.2014.12.029. PMID:25618570.
[98] Andrés AM, Burgos L, López Gutiérrez JC, et al. Treatment protocol for extravasation lesions[J]. Cir Pediatr, 2006, 19(3):136-139. PMID:17240942.
[99] Casanova D, Bardot J, Magalon G. Emergency treatment of accidental infusion leakage in the newborn:report of 14 cases[J]. Br J Plast Surg, 2001, 54(5):396-399. DOI:10.1054/bjps.2001.3593. PMID:11428769.
[100] Ching DL, Wong KY, Milroy C. Paediatric extravasation injuries:a review of 69 consecutive patients[J]. Int J Surg, 2014, 12(10):1036-1037. DOI:10.1016/j.ijsu.2014.08.355. PMID:25150804.
[101] Cochran ST, Bomyea K, Kahn M. Treatment of iodinated contrast material extravasation with hyaluronidase[J]. Acad Radiol, 2002, 9(Suppl 2):S544-S546. DOI:10.1016/s1076-6332(03)80288-x. PMID:12188333.
[102] Crowther DM, Buck ML, McCarthy MW, et al. Improving pediatric adverse drug event reporting through clinical pharmacy services[J]. J Pediatr Pharmacol Ther, 2011, 16(4):285-290. DOI:10.5863/1551-6776-16.4.285. PMID:22768013. PMCID:PMC3385043.
[103] Humphreys J, Johnston JH, Richardson JC. Skin necrosis following intravenous noradrenaline[J]. Br Med J, 1955, 2(4950):1250-1252. DOI:10.1136/bmj.2.4950.1250. PMID:13269844. PMCID:PMC1981272.
[104] Coffman JD, Cohen RA. Intra-arterial vasodilator agents to reverse human finger vasoconstriction[J]. Clin Pharmacol Ther, 1987, 41(5):574-579. DOI:10.1038/clpt.1987.74. PMID:3105944.
[105] Odom B, Lowe L, Yates C. Peripheral infiltration and extravasation injury methodology:a retrospective study[J]. J Infus Nurs, 2018, 41(4):247-252. DOI:10.1097/NAN.0000000000000287. PMID:29958261. PMCID:PMC6082416.
[106] Siwy BK, Sadove AM. Acute management of dopamine infiltration injury with Regitine[J]. Plast Reconstr Surg, 1987, 80(4):610-612. DOI:10.1097/00006534-198710000-00024. PMID:3659173.
[107] Subhani M, Sridhar S, Decristofaro JD. Phentolamine use in a neonate for the prevention of dermal necrosis caused by dopamine:a case report[J]. J Perinatol, 2001, 21(5):324-326. DOI:10.1038/sj.jp.7200493. PMID:11536027.
[108] 黄一梅. 小儿静脉输液致药液渗漏的护理干预[J]. 吉林医学, 2014, 35(11):2455-2456.
[109] 邓陵, 史源, 刘蕾. NICU危重新生儿输液渗漏致皮肤损伤的原因分析及防治[J]. 重庆医学, 2013, 42(6):716-718. DOI:10.3969/j.issn.1671-8348.2013.06.046.
[110] 吕义荣, 孙慧, 谢集建. 局部减压法辅助治疗早产儿静脉输注脂肪乳外渗[J]. 护理学杂志, 2013, 28(21):34-35. DOI:10.3870/hlxzz.2013.21.034.
[111] 陈正珊, 郭晓萍. 局部减压加湿敷与按摩处理新生儿严重输液外渗的临床应用[J]. 广东医学, 2010, 31(14):1894-1896. DOI:10.3969/j.issn.1001-9448.2010.14.053.