Nursing experience in the care of a critically ill SCID child with incontinence-associated dermatitis
一例SCID危重症患儿并发失禁性相关皮炎的护理体会

摘要

目的 总结重度联合免疫缺陷病（SCID）危重患儿失禁性皮炎的护理经验。方法 回顾性分析1例SCID危重患儿并发失禁性皮炎的临床资料，总结临床护理要点。结果 在积极抗感染、皮肤管理、胸腺法新提高免疫力和营养支持等治疗的基础上，实施精细化皮肤护理、个体化创面管理等措施后，患儿肛周皮肤红肿，破损程度显著减轻，创面渗液减少，新生上皮组织逐渐覆盖破损区域，皮肤完整性及屏障功能得到有效修复。结论 SCID患儿免疫力存在严重缺陷致患儿皮肤屏障功能减弱，皮肤感染风险增加，SCID患儿的皮肤问题本质是免疫缺陷的外在表现，治疗需以免疫重建为核心，同时重视皮肤感染的预防与护理。

Abstract

Objective To summarize the nursing experience for incontinence-associated dermatitis in critically ill Severe Combined Immunodeficiency (SCID) children.
Methods A retrospective analysis of clinical data from one critically ill SCID child with incontinence-associated dermatitis was conducted to summarize key clinical nursing points.
Results Based on treatments such as active anti-infection, skin management, thymosin alpha-1 to enhance immunity, and nutritional support, measures including refined skin care and individualized wound management were implemented. The child's perianal skin redness and swelling, as well as the degree of damage, were significantly reduced. Wound exudate decreased, and new epithelial tissue gradually covered the damaged area, effectively restoring skin integrity and barrier function.
Conclusion   SCID children have severe immune defects leading to weakened skin barrier function and increased risk of skin infection. Skin problems in SCID children are essentially an external manifestation of immune deficiency. Treatment should focus on immune reconstitution, while also emphasizing the prevention and nursing of skin infections.