应用Braden量表联合近红外光谱仪评估ICU患者压疮发生的研究  

Application of the Braden Scale and near infrared spectroscopy in the risk assessment of pressure ulcers in intensive care unit patients

作　　者：姜丽萍[1] 张龙[2] 陈丽莉[3] 潘莹莹[1] 崔飞飞[1] 

机构地区：[1]温州医科大学护理学院,温州市325035 [2]荆州市第一人民医院护理部 [3]温州医科大学附属第一医院护理部

出　　处：《中华护理杂志》2014年第8期901-904,共4页Chinese Journal of Nursing

基　　金：国家自然基金项目(编号:81372064);浙江省科技厅项目(编号:2012C33061)

摘　　要：目的探讨局部持续受压对组织血供的影响,评估患者压疮风险,为压疮早期监测提供依据。方法随机选取ICU住院患者117例,应用近红外光谱仪监测患者骶尾部组织氧饱和度,Braden量表进行压疮危险因素评估,采用灵敏度、特异度、阳性及阴性预测值和受试者工具特性曲线(ROC)评价近红外光谱仪对压疮的预测效果。结果有压疮者Braden评分为(12.23±1.67)分,未发生者为(13.14±1.48)分,差异有统计学意义(P<0.05)。随ICU住院时间的延长,骶尾部组织氧饱和度(rSO2)持续下降。Braden评分评为中、高度压疮危险组,患者局部rSO2测量显著低于轻度压疮危险组;ROC曲线下面积显示,局部组织rSO2参数对压疮判断优于Braden量表评分,两者结合可提高压疮早期判断的有效性和可靠性。结论应用近红外光谱法结合Braden量表评估有利于临床早期压疮的监测。Objective To monitor the change of regional oxygenation saturation（r SO2） and assess the risks of pressure ulcer in intensive care unit patients. Methods Totally 117 intensive care unit patients were recruited in this study. The near infrared spectroscopy was used to monitor the change of rSO2 in the sacrum areas and the Braden Scale was used to assess the risks of pressure ulcers. The sensitivity, specificity, positive predictive value, negative predictive value and area under the ROC were calculated to determine the predictive validity of the Braden scale and the near infrared spectroscopy for pressure ulcers. Results A significant difference was found in the average scores of Braden Scale between patients with pressure ulcers and those without pressure ulcers（P〈0.05）. The rSO2 of sacrum tissues showed a decreasing trend along with the increased hospital stay. The predictive value of rSO2 for pressure ulcers was better than the Braden Scale, and the Braden Scale combined with rSO2 in- creased the clinical value of early detection of pressure ulcers. Conclusions The Braden Scale combined with the near infrared spectroscopy can be used for the early detection of pressure ulcers.

关 键 词：重症监护病房 压疮 近红外光谱 局部组织氧饱和度 

分 类 号：R473[医药卫生—护理学]