压疮风险预警系统在胸腰段骨折手术患者压疮管理中的效果评价  

Efficacy evaluation of pressure ulcer risk warning system in pressure ulcer management in patients undergoing thoracolumbar fracture surgery

作　　者：李温霞[1] 孙静 李育红[1] 尹红梅[1] 刘宁[1] 樊孝文 高延征[3] 陈书连[3] Li Wenxia;Sun Jing;Li Yuhong;Yin Hongmei;Liu Ning;Fan Xiaowen;Gao Yartzheng;Chen Shulian(Operation Department, People's Hospital of Henan Province, Zhengzhou 450001, China;Operation Department, Fuwai Central China Cardiovascular Hospital, Zhengzhou 450001, China;Department of Orthopedics, People's Hospital of Henan Province, Zhengzhou 450001, China)

机构地区：[1]河南省人民医院手术部,郑州450001 [2]阜外华中心血管病医院手术部,郑州450001 [3]河南省人民医院骨科,郑州450001

出　　处：《中华创伤杂志》2019年第5期460-465,共6页Chinese Journal of Trauma

基　　金：河南省医学科技攻关计划(201702224).

摘　　要：目的探讨压疮风险预警系统在胸腰段骨折手术患者压疮管理中的效果.方法采用回顾性病例对照研究分析2016年10月-2018年9月河南省人民医院收治的120例胸腰段骨折行后路椎弓根螺钉固定椎间植骨融合手术治疗患者的临床资料,其中男76例,女44例;年龄45-80岁[(59.2±7.2)岁]。60例采用压疮风险预警系统进行护理(预警组),60例使用纸质评估表进行压疮管理(对照组)。比较两组填写压疮风险评估表用时、压疮预防措施执行得分及两组患者压疮发生率、视觉模拟评分(VAS)和患者满意度。结果对照组和预警组压填写压疮风险评估表用时分别为(⑵.5±9.0)min和(11.3±2.0)min(P<0.01),压疮预防措施执行得分分别为(85.9±3.8)分和(96.0±2.2)分(P<0.01)。对照组和预警组压疮发生率分别为25%(15/60)和3%(2/60)(P<0.01)。对照组术前、术后6,24,48,72hVAS分别为(7.3±1.3)分、(3.7±1.1)分、(3.2±0.9)分、(2.4±1.0)分、(2.3±0.8)分,预警组分别为(7.4±1.3)分、(2.9±0.7)分、(2.4±0.7)分、(1.8±0.7)分、(1.6±0.8)分,两组术前VAS比较差异无统计学意义(P>0.05),术后6,24,48,72hVAS比较,差异有统计学意义(P均<0.01),对照组满意度得分为(94.6±1.4)分,预警组满意度得分为(98.3±1.1)分(P<0.01).结论对于胸腰段骨折行后路椎弓根螺钉固定椎间植骨融合手术的患者,压疮风险预警系统使用方便,可降低患者压疮发生率,从而减轻患者疼痛,提高患者的满意度。Objective To investigate the effect of pressure ulcer risk warning system in the pressure ulcer management in patients undergoing thoracolumbar fracture surgery. Methods A retrospective case control study was performed to analyze the clinical data of 120 patients with thoracolumbar fracture who underwent posterior thoracolumbar pedicle screw fixation and intervertebral bone graft fusion surgery at People's Hospital of Henan Province from October 2016 to September 2018. There were 76 males and 44 females, aged 45-80 years [( 59. 2 ±7.2) years ]. A total of 60 patients received treatment and care under the pressure ulcer early warning system ( early warning group), while 60 patients were given assessment form for pressure ulcer management ( control group). The time of filling in the assessment form, the implementation score of pressure ulcer prevention measures, the incidence of pressure ulcer, visual analogue pain score ( VAS) and patient satisfaction were compared between the two groups. Results In the control group and early warning group, the time of filling in the form was (121.5 ±9.0) minutes and ( 1 1. 3 ±2.0) minutes ( P < 0. 01 ), the implementation score of pressure ulcer prevention measures was ( 85. 9 ±3.8) points and ( 96. 0 ± 2. 2) points ( P < 0. 01 ), and the pressure ulcer incidence was 25%( 15 patients) and 3%(two patients), respectively ( P < 0. 01 ). In the control group, the preoperative VAS was (7.3 ±1.3) points, and the VAS at 6 hours, 24 hours, 48 hours, 72 hours after operation were (3.7 ± 1.1) points,(3.2 ± 0. 9 ) points,(2.4 ± 1.0) points,(2.3 ± 0. 8 ) points, respectively. In the early warning group, the preoperative VAS was ( 7. 4 ± 1.3)points, and the VAS at 6 hours, 24 hours, 48 hours, 72 hours after operation were ( 2. 9 ± 0.7) points,(2.4 ±0.7) points,(1.8 ±0.7) points,(1.6 ±0.8) points, respectively. There was no significant difference in preoperative VAS between the two groups ( P〉0.05 ), while significant differences were found between the postoperative VAS ( P <

关 键 词：压力性溃疡 手术室 脊柱骨折 风险预警系统 

分 类 号：R473.6[医药卫生—护理学]