心血管手术患者术中压力性损伤现状及相关因素研究  

Current situation and related factors of intraoperative pressure ulcers in adult patients with cardiovascular surgery

作　　者：陈沅 吴蓓雯[2] 钱蒨健[2] 王维[2] 奚蓓华[2] CHEN Yuan;WU Beiwen;QIAN Qianjian;WANG Wei;XI Beihua(Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China;Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China)

机构地区：[1]上海交通大学护理学院,上海200025 [2]上海交通大学医学院附属瑞金医院,上海200025

出　　处：《上海护理》2019年第2期18-24,共7页Shanghai Nursing

摘　　要：目的调查成人心血管手术患者手术压力性损伤发生的现状,探讨其相关因素,为实施有针对性的护理干预提供依据。方法回顾性调查2016年2—11月于上海交通大学医学院附属瑞金医院实施心血管手术的成人患者1163例,分析手术压力性损伤发生的现状;按国际压疮分类标准将患者分为观察组和对照组,收集一般情况、生化指标、手术情况、药物使用、体外循环等资料,通过单因素分析和建立Lo-gistics回归方程,探讨患者手术压力性损伤发生的高危因素。结果成人心血管手术压力性损伤的发生率为19.86%; Logistic回归分析结果显示,年龄≥70周岁,术前低前白蛋白、高血红蛋白、高血钠、高血钾,吸烟史,高血压史,以及术中低体温、低平均动脉压是心血管手术压力性损伤发生的高危因素。结论手术室护理人员应关注心血管手术压力性损伤发生的高危人群,提供相关护理干预,以提高围手术期护理质量。Objective To investigate the current situation of intraoperative pressure ulcers in adult patients with cardiovascular surgery, and to explore the related factors to lay the foundation for the implementation of targeted nursing intervention. Methods A total of 1 163 adult patients with cardiovascular surgery were selected from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, during February and November 2016. The current situation of intraoperative pressure ulcers was analyzed. According to National Pressure Ulcer Advisory Panel′s Updated Pressure Ulcer Staging System, the patients were divided into pressure ulcer group and non-pressure ulcer group. The general condition, biochemical indices, surgical situation, drug usage and extracorporeal circulation data were collected. The related factors of intraoperative pressure ulcers were explored by single factor analysis and logistic regression analysis. Results The incidence rate of intraoperative pressure ulcers was 19.86%. Logistic regression analysis showed that age over 70 years, low preoperative prealbumin, high preoperative hemoglobin, high preoperative sodium, high preoperative potassium, smoking history, hypertension history, and intraoperative hypothermia and low mean arterial pressure were the related factors of intraoperative pressure ulcers. Conclusion The nursing staff should pay attention to the population at high risk, and provide targeted nursing interventions.

关 键 词：心血管手术 压力性损伤 相关因素 调查研究 

分 类 号：R473.54[医药卫生—护理学]