婴幼儿活体肝移植术后枕部压力性损伤的影响因素分析  

Risk factors of postoperative occipital pressure injury among pediatric patients undergoing liver transplantation

作　　者：陈哲颖[1] 姜建平 周穗[1] 陆瑾 CHEN Zheying;JIANG Jianping;ZHOU Sui;LU Jin(Operation Room,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院手术室,200127

出　　处：《中国护理管理》2021年第7期1098-1101,共4页Chinese Nursing Management

基　　金：上海交通大学医学院科技基金项目(Jyhz1801)。

摘　　要：目的:分析婴幼儿活体肝移植术后枕部压力性损伤发生的危险因素。方法:前瞻性观察并收集我院2018年10月至2019年12月行活体肝移植术的婴幼儿临床手术资料以及术后枕部压力性损伤发生情况,分析枕部压力性损伤发生的相关危险因素。结果:220例接受活体肝移植的婴幼儿中,枕部压力性损伤的发生率为6.4%(14/220)。术前枕部受压处皮肤与术中鼻咽核心温度差值>0.7℃、术前枕部受压处与其术中外延2 cm处皮肤温度差值>1.0℃、术前与术后枕部受压处皮肤温度最大差值>1.0℃,分别是影响术后枕部压力性损伤的独立危险因素。结论:建议对活体肝移植术婴幼儿术前及术中枕部及其周围皮肤温度进行实时监测,必要时需要采取临床干预以预防压力性损伤的发生。Objective:To analyze the risk factors of occipital pressure,injury after living donor liver transplantation in in infants and young children.Methods:Prospectively observed and collected clinical data and postoperative occipital pressure injury in pediatric patients who received living donor liver transplantation in our hospital from October 2018 to December 2019,and analyzed the related risk factors of occipital pressure injury.Results:The incidence of occipital pressure injury was 6.4%(14/220).The independent risk factors for occipital pressure injury were the temperature difference between the occipital compression area pre-operation and the core of nasopharynx during operation>0.7℃,the temperature difference between the occipital compression area pre-operation and its peripheral extension 2 cm area during the operation>1.0℃,the skin temperature difference of the occipital compression area pre-operation and post-operation>1.0℃.Conclusion:It is recommended that the occipital and surrounding skin temperature of pediatric undergoing living donor liver transplantation should be monitored in real time.Protective intervention should be taken to prevent the occurrence of pressure injury for those susceptible pediatric.

关 键 词：活体肝移植 婴幼儿 枕部压力性损伤 温度差值 危险因素 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]