经皮氧分压/经皮二氧化碳分压监测在急诊留观患者压疮早期预警中的应用价值  

The value of transcutaneous oxygen pressure/transcutaneous carbon dioxide pressure monitoring in early warning of the observing patients in emergency department

作　　者：张敏[1] 庞思卓[1] 吕慧 孙波[1] 李苹[1] 张琳[1] 吕明[2] Zhang Min;Pang Sizhuo;Lyu Hui;Sun Bo;Li Ping;Zhang Lin;Lyu Ming(Emergency Department,Qilu Hospital of Shandong University,Jinan 250012,China;Research Office, Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院急诊医学科,济南250012 [2]山东大学齐鲁医院科研处,济南250012

出　　处：《中国实用护理杂志》2019年第3期166-171,共6页Chinese Journal of Practical Nursing

基　　金：山东省医药卫生科技发展计划(2016WS0346);山东省自然科学基金(ZR2015PH037).

摘　　要：目的分析急诊留观患者压疮高危风险早期预警的相关因素,探讨经皮氧分压(TcPO2)和经皮二氧化碳分压(TcPCO2)监测在急诊留观患者压疮早期预警中的应用价值。方法连续纳入急诊留观患者186例,应用TcPO2/TcPCO2监测仪监测患者前胸部及骶尾部组织的氧合状况,Braden量表进行压疮危险因素评估,采用受试者工具特性曲线(ROC)评价TcPO2/TcPCO2监测对压疮的早期预测效果。结果Logistic回归结果显示,TcPO2 CV及PO2分别是患者Braden评分为高危组的独立危险因素。ROC曲线下面积显示,TcPO2 CV对于Braden评分为高危组具有较好的预测价值,并确定其cut-off值为20%,即TcPO2 CV≥20%者Braden评分高危,压疮发生潜在可能性大。结论TcPO2 CV是急诊留观患者高风险压疮发生的独立危险因素,对于压疮高危风险早期具有较好的预测价值。TcPO2 CV≥20%者发生压疮潜在可能性大。Objective To analyze the relevant factors of early warning in emergency patients with high risk of acute sores,explore the application value of transcutaneous oxygen pressure (TcPO2) and transcutaneous carbon dioxide pressure (TcPCO2) monitoring in the early warning of emergency patients with pressure ulcers.Methods This was a study of 186 consecutive emergency patients who were under care in the emergency department. The transcutaneous oxygen/carbon dioxide pressure monitor was used in monitoring the oxygen saturation of the skin of sacrococcygeal region and the chest. Meanwhile,the Braden scale was used in assessing risk factors for pressure ulcers and the receiver operating characteristic curve (ROC curve) was applied to evaluate the early prediction of pressure sore with TcPO2/TcPCO2 monitor.Results Implementing the logistic regression model with six indicators,this research concluded that TcPO2 CV and PO2 were independent risk factors for the development of Braden scale in patients with high risk. The area under the ROC curve showed that TcPO2 CV had a excellent predictive value for the high-risk group and determined its cut-off value to be 20%. Which means patient with both a value of TcPO2CV over 20% and a high risk of Braden scale had a larger possibility of pressure ulcers.Conclusions TcPO2 CV was an independent risk factor for patients under emergency care to develop pressure ulcers. A value of TcPO2CV over 20% indicated a high risk of pressure ulcers.

关 键 词：BRADEN评分 急诊留观 经皮氧分压/经皮二氧化碳分压 压力性损伤 胸骶经皮氧分压变异率 

分 类 号：R472.2[医药卫生—急诊医学]