医院获得性压疮原因分析与预防措施  

Hospital-acquired pressure ulcers cause analysis and preventive measures

作　　者：杨雪芳[1] 姚建琴[1] 蒋琪霞[4] 王祖晶 宋莎莎[3] 

机构地区：[1]南京医科大学附属苏州医院护理部,215001 [2]南京医科大学附属苏州医院肿瘤内科,215001 [3]南京医科大学附属苏州医院心内科,215001 [4]南京军区南京总医院门诊伤口护理中心,210002

出　　处：《中华现代护理杂志》2016年第27期3857-3861,共5页Chinese Journal of Modern Nursing

基　　金：南京军区医药卫生科研基金课题（MS117）

摘　　要：目的：分析综合医院住院患者获得性压疮发生的原因和预防措施,为加强医院压疮管理对策提供依据。方法采用回顾性研究收集2012年1月—2014年12月期间发生的201例医院获得性压疮患者的相关资料,进行描述性统计学分析导致压疮发生的原因、高发科室和高发部位,提出预防建议。结果肿瘤科占比最高（33.83％）,最常见的部位是尾骶部,占59.20％,压疮分期最多见的是Ⅱ期压疮,占76.12％；64.67％发生于住院2周内。 Braden评分〈12分者占58.21％,贫血者占72.14％,低蛋白血症者占75.62％,疼痛或胸腹水引起的强迫体位占26.87％,医疗器械压迫占10.95％。87.56％使用了减压垫,41.79％落实每2小时翻身一次。62.19％按指南实施了皮肤护理,38.81％经口或静脉营养支持。95.52％发生后及时上报护理部,1.99％通过查房发现,1.49％为患者或家属举报,1.00％在查阅病历时发现。结论肿瘤患者是院内压疮的高发人群,尾骶部为高发部位,Ⅱ期压疮为主,多发于住院2周内,好发于有压疮发生风险、低蛋白、贫血、强迫体位、无法落实定时翻身的患者。建议对肿瘤患者,特别是有癌痛和营养不良、强迫体位的肿瘤患者要加强预防。Objective To analysis the causes and preventive measures of acquired pressure ulcers in hospitalized patients, and to provide evidences and references for strengthening hospital management of pressure ulcers.Methods We took a retrospective study to collect relevant information of 201 patients with hospital-acquired pressure ulcers from January 2012 to December 2014, and conducted a descriptive statistical analysis on the cause of the developed, high-risk departments and high-risk areas, then came up with preventive suggestions.Results The high incidence of 201 hospital-acquired pressure ulcers was oncology department, which accounted for 33.83%;the most common part was the sacrococcygeal region, which accounted for 59.2%;stage II was the most common stage of pressure ulcer, which accounted for 76. 12%; 64. 67% of the pressure ulcers happens within the first two weeks in hospital. Braden scoring less than 12 points that accounted for 58. 21%;anemia accounted for 72. 14%; hypoalbuminemia accounted for 75. 62%; forced postures caused by pain or hydrothorax and ascite accounted for 26.87%; medical equipment pressure accounted for 10.95%. The use of vacuum pad accounted for 87.56%;turning over once every 2 hours accounted for 41.79%. Skin nursing according to the guide accounted for 62. 19%; nutritional support through the mouth or vein accounted for 38.81%. Reporting to the nursing department timely after the occurrence accounted for 95.52%; found in ward rounds accounted for 1.99%; reported by patients or their families accounted for 1.49%; failure to report and found in the medical records accounted for 1.00%,the patient or family members to report accounted for 1.49%. Conclusions Cancer patients are high-risk groups of nosocomial pressure ulcers. The sacrococcygeal region is the high-risk area;stage II is the most common stage, and most of them happens within the first 2 weeks in hospital. Main reasons are hypoalbuminemia, anemia, forced postures, unable to turn over periodically, and the preventive care implement

关 键 词：回顾性研究 医院获得性压疮 原因分析 对策 

分 类 号：R473[医药卫生—护理学]