重症康复患者压疮发生的影响因素分析  

Influencing Factors of Pressure Ulcer in Critically Ill Patients

作　　者：王莉[1] 蔡钱婷 陈萍[1] WANG Li;CAI Qianting;CHEN Ping(Huashan Hospital,Fudan University,Shanghai 201206,China)

机构地区：[1]复旦大学附属华山医院,上海201206

出　　处：《康复学报》2018年第5期25-29,36,共6页Rehabilitation Medicine

基　　金：上海市卫计委重要薄弱学科建设项目(2015ZB0401)

摘　　要：目的:探讨重症康复患者压疮发生的影响因素,为临床预防压疮提供依据。方法:采用病例对照研究,收集在本院发生压疮的30例重症康复患者作为压疮组,将同一时期入院的30例未患压疮的重症康复患者设为对照组,通过病史、实验室检查及简单问卷了解患者入院时的临床特征。单因素及多因素logistic回归分析压疮发生的影响因素。结果:与对照组比较,压疮组年龄、尿失禁比例和跌倒分值更高,而高中及以上文化程度的比例、Braden评分、采用Q2H翻身比例和陪护人数更低;单因素logistic回归分析显示,高龄(OR=1.055,95%CI:1.015～1.097)、尿失禁(OR=4.500,95%CI:1.094～18.503)、跌倒分数较高(OR=3.201,95%CI:1.769～5.792)是压疮发生的危险因素,而高中及以上的文化程度(OR=0.318,95%CI:0.108～0.938)、Braden评分较高(OR=0.396, 95%CI:0.233～0.675)、Q2H翻身(OR=0.222,95%CI:0.054～0.914)和陪护人数多(OR=0.058,95%CI:0.008～0.424)则是压疮发生的保护因素;多因素logistic回归分析显示,在校正其他可能的影响因素后,跌倒分数和Braden评分是压疮发生的独立影响因素(跌倒分数:aOR=3.019,95%CI:1.281～7.114;Braden评分:aOR=0.397,95%CI:0.160～0.983)。结论:Braden评分和跌倒分数与压疮的发生密切相关,在今后的临床工作中对Braden评分较低、跌倒分数较高的重症康复患者应重点护理。Objective: To explore the influencing factors of pressure ulcer in critically ill patients and to provide the evidence for the prevention of clinic pressure ulcer. Methods: A casecontrol study was applied to this research. Thirty critically ill patients with pressure ulcers were collected in our hospital as the case group,and 30 patients who were admitted to the hospital during the same period without severe pressure ulcers were selected as the control group, and their clinic characteristics data were collected from clinical records, laboratory tests and by simple questionnaires. Univariate and multivariate logistic regression analysis were applied to find out the influencing factors of pressure ulcer. Results: Compared to the control group, the age, fall score and proportion of urinary incontinence in the case group were higher, while the degree of high school education or above that, Q2 H, Braden score and number of caregivers in the case group was lower. Univariate logistic regression showed that higher age(OR=1.055, 95% CI: 1.015-1.097), urinary incontinence(OR=4.500, 95% CI: 1.094-18.503), higher fall score(OR=3.201, 95% CI: 1.769-5.792) were risk factors, while higher education level(OR=0.318, 95% CI: 0.108-0.938), higher Braden score(OR=0.396, 95% CI: 0.233-0.675), Q2 H turning over(OR=0.222, 95% CI: 0.054-0.914) and more caregivers(OR=0.058, 95% CI: 0.008-0.424) were the protective factors for pressure ulcer. After adjustment for covariates in multivariate logistic regression, only Braden score(aOR=0.397, 95% CI: 0.160-0.983) and fall score(aOR=3.019, 95% CI: 1.281-7.114) were independent factors of pressure ulcer. Conclusion: The Braden score and fall score are closely related to pressure ulcer, which indicates that clinical workers should pay more attention to those critically ill patients with low Braden scores or high fall scores in future work.

关 键 词：重症康复患者 压疮 影响因素 BRADEN评分 跌倒分数 

分 类 号：R473[医药卫生—护理学]