头面部手术患者术中压力性损伤的影响因素及护理措施  

Influencing factors and nursing measures of intraoperative pressure injuries in patients undergoing craniofacial surgery

作　　者：杨莹 陈嘉萍 潘颖欣 徐朋 YANG Ying;CHEN Jiaping;PAN Yingxin;XU Peng(Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510010,China)

机构地区：[1]广东省人民医院,广东省医学科学院,广州510010

出　　处：《实用医学杂志》2020年第21期3005-3008,共4页The Journal of Practical Medicine

基　　金：2019年汕头大学医学院护理研究专项基金项目(编号:NU201906)。

摘　　要：目的探讨头面部外科手术患者在手术中发生压力性损伤的影响因素及采取针对性的护理干预措施。方法通过便利抽样,回顾性分析我院2018年8-12月神经外科、口腔颌面外科、耳鼻喉头颈外科行择期外科手术治疗166例患者围手术期压力性损伤相关因素,利用二元Logistic回归方程分析危险因素,探讨合理的护理措施。结果166例研究对象中,术后皮肤出现压力性损伤6例(部位主要为髂骨、脚踝、骶尾部),压疮发生率为3.61%。术前血红蛋白、术前白蛋白、手术时间、出血量、受压点皮肤类型、术中施加的压力是影响头面部手术患者发生压力性损伤的影响因素,差异有统计学意义(P<0.05)。结论术前血红蛋白、白蛋白偏低、术前受压点皮肤类型、手术时间长、术中出血多的患者更容易出现压力性损伤,掌握头面部手术患者围术期的护理要点,有效预防及改善上述围术期状态,有针对性的采取护理措施,降低手术压力性损伤的发生率。Objective To explore the influencing factors of pressure injury in patients undergoing craniofacial surgery and take targeted nursing intervention measures.Methods Through convenience sampling,we retrospectively analyzed perioperative pressure injury related factors of 166 patientsfrom the neurosurgery,oral and maxillofacial surgery,otohinolaryngology-head and neck surgery in our hospital from August to December 2018.and the logistic multiple regression equation was used to analyze the risk factors and explore reasonable nursing measures.Results Among the 166 subjects,6 cases had postoperative skin pressure injuries(mainly affect the iliac bones,ankles,and sacrococcygeal),the incidence of pressure sore was 3.61%.Preoperative hemoglobin,preoperative albumin,operative time,bleeding volume,pressure point skin type and the pressure applied during the operation are the influencing factors of the pressure injury in the craniofacial surgery patients,and the difference is statistically significant(P<0.05).Conclusion Patients with low preoperative hemoglobin or albumin,preoperative pressure point skin type,long operative time,and excessive intraoperative bleeding volume are more likely to develop pres-sure injuries.Master the perioperative nursing points for patients undergoing craniofacial surgery to effectively prevent and improve the above-mentioned perioperative state,and take targeted nursing measures may reduce the incidence of surgical pressure injuries.

关 键 词：头面部手术 压力性损伤 影响因素 护理措施 

分 类 号：R472.3[医药卫生—护理学]