外科重症病人压疮高危因素分析及护理对策  

Analysis on high risk factors of pressure ulcers in surgical critically ill patients and nursing countermeasures

作　　者：王欣然[1] 韩斌如[1] 张建华[2] 

机构地区：[1]首都医科大学宣武医院 [2]山西医科大学第一医院

出　　处：《护理研究（中旬版）》2013年第6期1677-1679,共3页Chinese Nursing Researsh

基　　金：2010年度首都中医药与护理专项课题;编号:10ZYH12

摘　　要：[目的]探讨外科重症病人压疮相关危险因素及护理对策。[方法]采用前瞻性队列研究设计,应用Braden量表筛选出105例Braden评分≤12分的病人为研究对象,分为压疮高度风险组(Braden评分10分～12分)和极度风险组(Braden评分6分～9分)。应用APACHEⅡ评分量表收集19项指标,比较两组独立样本间各项指标的差异,找到可能的危险因素;通过Logistic回归分析筛选出有意义的高危因素。[结果]单因素分析显示,极度风险组病人的平均动脉压、24h尿量低于高度风险组,而APACHEⅡ评分高于高度风险组,差异有统计学意义(P<0.01);多因素Logistic回归分析显示,平均动脉压低是导致压疮风险的高危因素(P<0.01)。[结论]护士应将休克病人视为外科ICU压疮防控的重点关注对象,将低血压作为重点关注的高危因素;树立休克抢救同时防控压疮的意识,积极配合医生尽快恢复有效循环血量,作好休克早期积极的液体复苏,并且在抢救的同时采取多种减压防控措施,有助于提高危重病人防控压疮的护理质量。Objective：To probe into the related risk factors of pressure ul- cers in severe surgical patients and its nursing countermeasures. Methods： Using prospective cohort study design,a total of 105 cases of patients with Braden score 412 points were screened and selected as the research objects by using Braden scale,and they were divided into high risk group （Braden score 10 - 12） and the extreme risk group （Braden score 6 - 9）. 19 indexes were collected by using APACHE Ⅱ Rating Scale,and they were compared among independent samples between both groups, so as to find out the pos- sible risk factors. And then to seek the meaningful high risk factors by re- gression Logistic analysis. Results： Univariate analysis showed that the mean arterial pressure and 24 h urine volume of patients in extreme risk group were significantly lower than those of patients in high risk group, the difference was statistically significant （P〈0. 01）. Multi - factor Logistic regression analysis showed that low mean arterial pressure was the high risk factor induced pressure ulcers（P〈0.01）. Conclusion：In surgical ICU pressure ulcers prevention and control, patients with shock should be re- garded as the focus, and hypotension as a focus of risk factors. It is helpful to improve the nursing quality during prevention and control of pressure ulcers in critically ill patients to establish the awareness of prevention and control of pressure ulcers at the same time of shock rescue, actively cooper- ating with the doctors as soon as possible to restore effective circulating blood volume of patients, do early fluid resuscitation for shock actively, and adopt a variety of vacuum prevention and control measures at the same time of rescue.

关 键 词：重症病人 压疮 危险因素 BRADEN量表 低血压 护理 

分 类 号：R473.6[医药卫生—护理学]