全程多维度皮肤管理对老年恶性梗阻性黄疸患者ERCP术后压力性损伤的预防分析  

Prevention effect of whole course multidimensional skin management on pressure injury after ERCP in elderly patients with malignant obstructive jaundice

作　　者：黄静 HUANG Jing(Ward 2, Department of Gastroenterology, People's Hospital of Tianjin, Tianjin 300400, China)

机构地区：[1]天津市人民医院消化内科2病房,300400

出　　处：《中国老年保健医学》2022年第1期144-147,共4页Chinese Journal of Geriatric Care

摘　　要：目的分析全程多维度皮肤管理对老年恶性梗阻性黄疸(MOJ)行经内镜逆行性胰胆管造影术(ERCP)患者术后压力性损伤发生的预防效果。方法随机选择2019年7月至2020年9月于我院收治的老年恶性梗阻性黄疸行ERCP患者98例为研究对象,其中对照组48例,试验组50例。对照组采用ERCP围术期常规护理,试验组在对照组护理方案基础上采用全程多维度皮肤管理。比较两组ERCP术后至出院前1周患者压力性损伤的发生率、发生程度和发生部位等差异;比较两组术后6h和7d患者人血白蛋白、血红蛋白水平的差异;比较两组护理工作满意度。结果试验组患者压力性损伤发生率为6.00%,显著低于对照组(22.92%),P<0.05。试验组主要为1期压力损伤,而对照组各期压力性损伤均有发生;试验组压力性损伤部位为骶尾部(45.40%)和髋部(18.20%),而对照组各部位压力性损伤均有发生。两组术后7d血红蛋白水平较术后6h显著升高,但对照组仍显著低于试验组(P<0.05)。两组患者术后7d人血白蛋白水平与术后6h并无显著差异,两组间比较亦无显著差异(P>0.05)。试验组患者对于服务态度、健康教育和活动指导的满意率均显著高于对照组(P<0.05)。结论全程多维度皮肤管理有效预防老年MOJ患者ERCP术后压力性损伤的发生,且有利于护理满意度的提升。Objective To analyze the preventive effect of whole course multi-dimensional skin management on postoperative pressure injury in elderly patients with malignant obstructive jaundice(MOJ)undergoing endoscopic retrograde cholangiopancreatography(ERCP).Methods 98 elderly patients with malignant obstructive jaundice who underwent ERCP in the outpatient department and digestive department of our hospital from July 2019 to September 2020 were randomly selected as the research objects,including 48 cases in the control group and 50 cases in the experimental group.The control group was treated with routine perioperative nursing of ERCP,and the experimental group was treated with whole course multi-dimensional skin management on the basis of the control group.The incidence,degree and location of stress injury from ERCP to 1 week before discharge were compared between the two groups;The levels of serum albumin and hemoglobin were compared between the two groups at 6 hours and 7 days after operation;Then compare the satisfaction of the two groups of patients with nursing work.Results The incidence of pressure injury in the experimental group was 6.00%,which was significantly lower than that in the control group(22.92%)(P<0.05).The experimental group was mainly stage 1 pressure injury,while the control group had pressure injury in all stages;The pressure injury sites in the experimental group were sacrococcygeal(45.40%)and hip(18.20%),while the pressure injury sites in the control group occurred.The hemoglobin level of the two groups was significantly higher at 7 days after operation than at 6 hours after operation,but it was still significantly lower in the control group than in the experimental group(P<0.05);There was no significant difference in serum albumin level between the two groups at 7 days and 6 hours after operation,and there was no significant difference between the two groups(P>0.05).The satisfaction rates of service attitude,health education and activity guidance in the experimental group were significantly hig

关 键 词：老年 恶性梗阻性黄疸 ERCP 压力性损伤 全程护理 多维度 

分 类 号：R473.6[医药卫生—护理学]