晚期肿瘤患者压疮预防措施及相关危险因素分析  

Influence factor and prevention of pressure ulcers in advanced tumor patients

作　　者：于水[1] 赵晓甦[2] 宋龄[1] 吕巍[1] 

机构地区：[1]吉林大学第一医院心血管诊疗中心,长春130021 [2]吉林大学第一医院护理部,长春130021

出　　处：《中华现代护理杂志》2014年第34期4338-4342,共5页Chinese Journal of Modern Nursing

摘　　要：目的：探讨晚期肿瘤患者压疮发生的危险因素及其预防措施。方法2010年7月1日开始实行压疮报告制度，对肿瘤患者进行压疮风险评估，制订防治计划。收集2010年1月1日—6月30日收治的612例和2013年1月1日—6月30日收治的632例晚期肿瘤患者的临床资料，比较压疮防治措施实施前后的发生率，应用修订版Braden量表对肿瘤患者压疮发生的影响因素及严重程度进行评估。结果2010年上半年和2013年上半年患者压疮的发生率分别为23．9％和18．2％，差异有统计学意义（χ2＝4．80，P＜0．05）。2013年上半年压疮患者的平均年龄为（76．2±2．3）岁，明显大于无压疮患者的（66．1±2．0）岁，差异有统计学意义（ t ＝23．37，P ＜0．01）。压疮患者的修订版Braden 量表评分为（11．3±1．1）分，低于无压疮患者的（20．4±1．7）分，差异有统计学意义（ t＝27．12，P＜0．01）。压疮的严重程度与患者所处环境的潮湿程度、活动情况、行动能力和是否有摩擦力及剪切力相关（P＜0．01）。结论压疮报告制度和预防措施有效。对于有患压疮风险的患者，应当尽早进行风险评估和预防，以降低预见压疮的发生或减缓预见性压疮的发展程度。Objective To compare the prevalence of pressure ulcers and prevention before and after a quality improvement program.Methods Descriptive comparative study based on two cross-sectional pressure ulcer surveys was conducted in 2010 and 2013.A total of 612 hospitalized patients in 2010 and 632 in 2013 were included.The pressure ulcers prevention mainly included pressure-reducing mattresses, planned repositioning and so on.Braden scale was used to estimate the effect factors and severity of pressure ulcers. Results Pressure ulcer prevalence was 23.9%in 2010 and 18.2%in 2013,and the difference was statistically significant （χ2 =4.80,P〈0.05）.The mean age of patients with pressure ulcers in first half year of 2013 were significantly older than those without （76.2 ±2.3 vs 66.1 ±2.0;t=23.37,P〈0.01）.Braden scale records of pressure ulcers patients was lower than that of patients without （11.3 ±1.1 vs 20.4 ±1.7;t =27.12,P〈0.01）.The severity of pressure ulcers was related to moisture, activity, mobility and friction and shear （〈0.01）.Conclusions Risk assessment as well as prevention should start early in the hospitalization in order to improve the life quality of patients.

关 键 词：护理 压疮 预防 质量评估 危险因素分析 

分 类 号：R473.73[医药卫生—护理学]