ICU患者压疮易患部位组织血氧变化的近红外光谱法监测分析  

Regional oxygenation of ICU patients′ tissue susceptible to pressure ulcer using near-infrared spectroscopy

作　　者：张龙[1] 陈丽莉[2] 孙熠[1] 潘莹莹[1] 崔飞飞[1] 代彦丽[1] 姜丽萍[1] 

机构地区：[1]温州医学院护理学院,浙江温州325035 [2]温州医学院附属第一医院护理部,浙江温州325035

出　　处：《护理学杂志》2012年第24期4-7,共4页

摘　　要：目的评估ICU患者压疮易患部位氧合状况的变化,为临床早期压疮监测预警提供参考。方法随机选取ICU住院患者117例,结合Braden评分进行压疮危险因素评估及积极护理干预,并应用近红外光谱仪监测患者压疮易患部位组织氧饱和度(rSO2)。结果不同压疮危险程度患者压疮易患部位rSO2随入住ICU时间的延长而降低,危险度越重rSO2越低(P<0.05,P<0.01)。同一时间点骶尾部rSO2低于肩胛部(P<0.05,P<0.01)。发生压疮者随护理干预进程rSO2逐渐回升、各时间点仍低于未发生压疮者(P<0.05,P<0.01)。结论受压后组织缺血缺氧、局部氧合作用改变是压疮发生的重要原因;近红外光谱法可应用于临床压疮易患组织的血氧监测、评估。Objective To explore oxygenation of local tissues susceptible to pressure ulcer by near-infrared spectroscopy （NIRS） a- mong ICU patients, and to help nurses recognize early warning signs of pressure ulcer. Methods A total of 117 ICU patients were selected randomly and were given active nursing intervention. The regional tissue oxygen saturation （rSO2） at the pressure-ulcer- prone skin sites was monitored through NIRS continuously. Results Patients at varied risks of pressure ulcer all had declining rSO2 at the pressure-ulcer-prone skin sites as their hospital stay lengthened the higher the risk of pressure ulcer, the lower the rSO2 （P〈0.05,P〈0.01）. On every single day, the value of rSO2 of scapula tissue was higher than that of sacrum tissue （P〈0.05, P〈0.01）. For those who developed pressure ulcer, the values of rSO2 gradually climbed back as nursing intervention progressed, and yet still lower than their concurrent counterparts measured in patients who didn＇t have pressure ulcer （P〈0.05, P〈O. 01）. Conclusion The pressurized skin has inadequate blood perfusion and changes in local oxygenation, which exert significant effect on pressure ulcer formation. NIRS can be utilized to monitor and assess local oxygenation of tissues susceptible to pressure ulcer.

关 键 词：ICU 危重患者 压疮 近红外光谱 血氧饱和度 

分 类 号：R471[医药卫生—护理学]