液体石蜡油涂抹预防腰椎后路手术病人压力性损伤的效果  

Effect of liquid paraffin oil in preventing pressure sores in lumbar surgery in prone position

作　　者：张莺 程文夫[1] ZHANG Ying;CHENG Wen-fu(Operating Room,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院手术室

出　　处：《骨科》2019年第5期466-469,共4页ORTHOPAEDICS

摘　　要：目的探讨液体石蜡油在预防腰椎后路手术病人俯卧位皮肤压力性损伤中的效果。方法选取2017年1月至2019年3月在我院行腰椎后路手术的病人300例,采用随机数字表法分为常规组、石蜡油组和液体敷料组,每组各100例。常规组采取常规俯卧位护理措施;石蜡油组在常规俯卧位护理的基础上,将液体石蜡油均匀涂抹于病人的前额、颧弓、下颌、锁骨、双前胸、髂骨、大腿根部至膝关节等受压部位;液体敷料组在上述涂抹部位采用液体敷料进行干预。记录三组病人术后皮肤受压情况,采用美国国家压力性损伤顾问小组(National Pressure Ulcer Advisory Panel, NPUAP)压力性损伤分期(2016年版)评估压力性损伤分期,比较三组病人的压力性损伤发生率。结果术后石蜡油组和液体敷料组各有2例发生Ⅰ期压力性损伤,发生率均为2%。常规组有10例发生压力性损伤(Ⅰ期压力性损伤8例,Ⅱ期压力性损伤2例),发生率为10%。石蜡油组和液体敷料组病人的压力性损伤发生率均显著低于常规组,组间比较差异有统计学意义(F=9.590,P<0.05)。结论液体石蜡油可以有效预防腰椎后路手术病人俯卧位皮肤压力性损伤的发生,是一种简单、安全、有效的方法,值得推荐。Objective To explore the effect of liquid paraffin oil in preventing skin pressure sore during lumbar surgery in prone position. Methods Three hundred patients undergoing lumbar surgery in our hospital from January 2017 to March 2019 were enrolled in this study and randomly divided into paraffin oil group(100 cases), liquid dressing group(100 cases) and routine group(100 cases). All groups were given nursing measures in conventional prone position. Additionally, in the paraffin oil group liquid paraffin oil was evenly applied to the forehead, zygomatic arch, mandible, clavicle, double fore chest, tibia, thigh root to knee joint and other compression parts of the patient;in the liquid dressing group, liquid auxiliary materials were applied to the above parts. The skin pressure of the patients in three groups were recorded. The National Pressure Ulcer Advisory Panel(NPUAP) Stress Injury Guide(2016 Edition) was used to evaluate the staging of stress injuries. The incidence of stress injuries was compared among the three groups. Results There were 2 cases of stage Ⅰ stress injury in the paraffin oil group and the liquid dressing group with the incidence rate being 2%. There were 10 cases of pressure injury in the conventional group with the incidence rate being 10%,including 8 cases of stage Ⅰ stress injuries, and 2 cases of stage Ⅱ pressure injury. The incidence of stress injury in the paraffin oil group and the liquid dressing group was significantly lower than that in the conventional group(P<0.05). Conclusion Liquid paraffin oil can effectively prevent the occurrence of skin pressure sores during lumbar surgery in prone position.

关 键 词：液体石蜡油 俯卧位 腰椎手术 压力性损伤 手术室护理 

分 类 号：R473.6[医药卫生—护理学]