探析重症监护室患者压疮易发的危险因素及Apache Ⅱ评分对压疮的预测价值分析  

Analysis of the risk factors of pressure ulcers in intensive care unit patients and the predictive value of ApacheⅡscore for pressure ulcers

作　　者：刘佳[1] 姜海[1] 王银娥[1] 周丙梅[1] LIU Jia;JIANG Hai;WANG Yin-e(Department of Emergency Surgery,First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院急诊外科,233000

出　　处：《中国现代药物应用》2021年第12期93-95,共3页Chinese Journal of Modern Drug Application

基　　金：蚌埠医学院自然科学重点项目(项目编号:BYKY2019103ZD)项目名称:研究ApacheⅡ评分内各项指标与压疮的发生关系及重症监护室患者压疮易发的危险因素。

摘　　要：目的探讨重症监护室患者压疮易发的危险因素及系统急性生理学及慢性健康状况评分系统Ⅱ(ApacheⅡ)评分对压疮的预测价值。方法 200例重症监护室压疮危险因素评估表(Braden)评分≤12分的患者,根据Braden评分分为压疮高危组(6分≤Braden评分<10分, 46例)与压疮危险组(10分≤Braden评分≤12分, 154例)。统计比较两组患者的临床资料,比较两组ApacheⅡ内各项指标评分及总分。结果两组年龄、呼吸频率、体温、动脉血pH值、血清肌酐、血清钾、白细胞计数、红细胞比容比较,差异无统计学意义(P>0.05);压疮高危组住院时间长于压疮危险组,平均收缩压、心率、动脉血氧分压(PaO_(2))、睁眼反应评分、运动反应评分和语言反应评分均低于压疮危险组,差异具有统计学意义(P<0.05);两组年龄评分比较,差异无统计学意义(P>0.05);压疮高危组免疫损害评分(3.49±0.54)分、生理指标评分(6.36±1.21)分、格拉斯哥昏迷指数(GCS)评分(5.22±0.84)分及总分(17.26±2.23)分均明显高于压疮危险组的(2.54±0.36)、(3.83±0.54)、(3.19±0.51)、(11.71±2.16)分,差异具有统计学意义(P<0.05)。结论重症监护室患者易发压疮是多因素共同作用的病理生理过程, ApacheⅡ评分可预测重症监护室患者压疮发生情况,有较高的应用价值。Objective To discuss the risk factors of pressure ulcers in intensive care unit patients and the predictive value of acute physiology and chronic health evaluationⅡ(ApacheⅡ)score for pressure ulcers.Methods According to the Braden score,200 patients with Braden score≤12 points in the intensive care unit were divided into pressure ulcer high-risk group(6 points≤Braden score<10 points,46 cases)and pressure ulcer risk group(10 points≤Braden score≤12 points,154 cases).The clinical data,ApacheⅡand ApacheⅡscore were compared between the two groups.Results There was no statistically significant difference in age,respiratory rate,body temperature,arterial blood pH,serum creatinine,serum potassium,white blood cells count,hematocrit between the two groups(P>0.05).The hospitalization time of pressure ulcer high-risk group was longer than that of pressure ulcer risk group,and systolic blood pressure,heart rate,arterial partial pressure of oxygen(PaO_(2)),eye response time,motor response time,language response time were lower than those of pressure ulcer risk group.All the difference was statistically significant(P<0.05).There was no statistically significant difference in age between the two groups(P>0.05).The immune damage score(3.49±0.54)points,physiological index score(6.36±1.21)points,Glasgow coma scale(GCS)score(5.22±0.84)points and total score(17.26±2.23)points of pressure ulcer risk group were obviously higher than(2.54±0.36),(3.83±0.54),(3.19±0.51),and(11.71±2.16)points of pressure ulcer high-risk group,and the difference was statistically significant(P<0.05).Conclusion The susceptibility to pressure ulcers in intensive care unit patients is a pathophysiological process of multiple factors.ApacheⅡscore can predict the occurrence of pressure ulcers in intensive care unit patients and has high application value.

关 键 词：重症监护室 系统急性生理学及慢性健康状况评分系统Ⅱ评分 压疮 

分 类 号：R632.1[医药卫生—外科学]