多功能丁字鞋预防压力性损伤的应用与研究  

Clinical application of multi-functional T-shape shoes in preventing stress injury

作　　者：廖兆丰 张晴[2] 方成[3] LIAO Zhaofeng;ZHANG Qing;FANG Cheng(Department of Severe Case Medicine,Central Hospital,Hubei,Wuhan 430024,China;不详)

机构地区：[1]湖北省武汉市中心医院重症医学科,430024 [2]湖北省武汉市中心医院外科,430024 [3]武汉轻工大学,武汉市430023

出　　处：《河北医药》2021年第1期90-93,97,共5页Hebei Medical Journal

摘　　要：目的探讨多功能丁字鞋对多功能丁字鞋下肢外固定患者足跟皮温、经皮血氧饱和度、足跟压疮发生率的影响。方法选取2017年1月至2018年1月住院治疗需要进行丁字鞋下肢外固定患者200例,根据随机数字表法分为对照组和观察组,每组100例,患者仅纳入一侧足为研究对象。对照组术后开始使用传统丁字鞋进行固定,观察组术后开始使用改良多功能丁字鞋进行固定。记录2组患者一般资料[性别、平均年龄、疾病类型、平均卧床时间、手术类型、Braden压疮风险评分、体重指数(BMI)、白蛋白水平、手术时间等]、足跟压强、足跟皮温、经皮血氧饱和度、GCQ评分和Likert分级、护士操作便利性VAS评分及压力性损伤情况。结果观察组足跟压强显著低于对照组(P<0.05);入组后第1天观察组足跟皮温显著升高(P<0.05);观察组皮温均显著高于对照组,差异有统计学意义(P<0.05)。2组足跟经皮血氧饱和度SpO2均显著升高(P<0.05);观察组经皮血氧饱和度SpO2均显著高于对照组,差异有统计学意义(P<0.05);患者入组前均未发生压力性损伤。观察组GCQ评分和Likert分级评分均显著高于对照组,差异有统计学意义(P<0.05);观察组的护士操作便利性VAS评分显著高于对照组,差异有统计学意义(P<0.05)。7 d后,对照组发生10例压力性损伤,其中1期压力性损伤8例,2期压力性损伤2例,压疮率8.00%;观察组发生2例压力性损伤,为1期压力性损伤,压疮率1.50%;2组压疮率差异有统计学意义(P<0.05)。结论改良丁字鞋足跟接触面积大,能显著减轻足跟压强,提高足跟皮温、经皮血氧饱和度及穿戴舒适度,降低未发生压力性损伤患者的术后足跟压疮发生率,值得推广使用。Objective To investigate the effects of multifunctional T-shape shoes on the skin temperature of heel,transcutaneous oxygen saturation and the incidence of heel pressure sore in the patients undergoing lower extremity external fixation.Methods A total of 200 patients who needed to be fixed with T-shaped shoes in our hospital from January 2017 to January 2018 were enrolled in the study,who were randomly divided into the control group and the observation group,with 100 cases in each group,and one foot only in every patients was enrolled in the study.The patients in control group were treated by traditional T shape shoes fixation after operation,however,the patients in observation group were treated by modified T shape shoes fixation after operation.The general data(gender,average age,disease type,average bed time,operation type,Braden pressure sore risk score,average BMI,average albumin level,average operation time),and heel pressure,heel skin temperature,transcutaneous oxygen saturation,GCQ score and Likert grade,nurse’s convenience VAS score and stress injury were observed and compared between the two groups.Results The heel pressure in observation group was significantly lower than that in control group(P<0.05).The SpO2 levels in both groups were increased significantly(P<0.05),moreover,which in observation group were significantly higher than those in control group(P<0.05).In addition the GCQ scores,Likert rating scores and VAS scores in observation group were significantly higher than those in control group(P<0.05).There were significant differences in the incidence rates of pressure injury and pressure sore rate between the two groups(P<0.05).Conclusion The improved T-shape shoes have a large heel contact area,which can significantly reduce heel pressure,improve heel skin temperature,transcutaneous oxygen saturation and wearing comfort degree,and reduce the incidence of heel pressure sore in patients without pressure injury,therefor,which is worthy of clinical application.

关 键 词：改良丁字鞋 压力性损伤 皮温 

分 类 号：R683[医药卫生—骨科学]