基于TcPO_(2)和TcPCO_(2)比较不同支撑面压力性损伤的效果研究  

Comparison of the effect of pressure injury on different support surfaces based on TcPO_(2) and TcPCO_(2)

作　　者：王志成[1] 苏琼[2] 李智[1] WANG Zhicheng;SU Qiong;LI Zhi(Anesthesia Surgery Room,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Prevention and Health Care Department,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院麻醉科手术室,400010 [2]重庆医科大学附属第二医院预防保健科,400010

出　　处：《重庆医学》2022年第6期987-990,共4页Chongqing medicine

基　　金：重庆市科卫联合医学科研重点项目(2019ZDXM050);重庆医科大学附属第二医院护理骨干科研资助计划项目(201904)。

摘　　要：目的探讨经皮氧分压(TcPO_(2))和经皮二氧化碳分压(TcPCO_(2))在评估不同支撑面患者术中受压部位压力性损伤的效果价值。方法选取2020年5-12月该院手术室仰卧位患者为研究对象,通过Scott触发点和Munro压疮风险评估量表筛选96例压力性损伤的高危患者,将术中骶尾部使用海绵垫的患者分为对照组,而使用啫喱垫的患者分为试验组,采用经皮气体测量仪测量两组骶尾部TcPO_(2)、TcPCO_(2)数据并观察变化情况。结果对照组和试验组受压部位解除压迫后皮肤受损情况比较,Ⅰ期压力性损伤分别为37.5%和20.8%,Ⅱ期为22.9%和8.4%,差异有统计学意义(P<0.05)。两组受压前和解除压迫后10 min的TcPO_(2)、TcPCO_(2)比较,差异无统计学意义(P>0.05);而受压部位受压20、60 min的TcPO_(2)、TcPCO_(2)比较,差异有统计学意义(P<0.05),且随着患者受压时间的增加,骶尾部皮肤组织TcPO_(2)逐渐降低,而TcPCO_(2)逐渐升高。结论监测TcPO_(2)和TcPCO_(2)可为术中受压部位寻找合适的支撑面提供客观依据。Objective To investigate the effective value of transcutaneous partial pressure of oxygen(TcPO_(2))and carbon dioxide(TcPCO_(2))in evaluating the pressure injury of the compression site in patients with different support surfaces.Methods Patients in the operating room were selected from May to December 2020.A total of 96 high-risk patients with pressure injury were selected by Scott trigger point and Munro pressure ulcer risk assessment scale.Patients with sponge pads in sacrococcygeal support surfaces were divided into control groups,and those with gel pads were divided into trial groups.The data of TcPO_(2) and TcPCO_(2) of sacrococcygeal were measured by the percutaneous gas meter,and the changes of the data were observed.Results After the removal of compression,the skin damage of the two groups were 37.5%and 20.8%in stageⅠ,22.9%and 8.4%in stageⅡ,with significant difference(P<0.05).There was no significant difference between TcPO_(2) and TcPCO_(2) before and ten minutes after decompression between the two groups(P>0.05).While the comparison between TcPO_(2) and TcPCO_(2) after 20 and 60 min of compression at the compression site was significantly significant(P<0.05).Meanwhile,TcPO_(2) gradually decreased in the sacral tail skin tissue,while TcPCO_(2) gradually increased,as the patient increased the compression time.Conclusion TcPO_(2) and TcPCO_(2) monitoring can provide an objective basis for finding the appropriate supporting surface during surgery.

关 键 词：经皮氧分压 经皮二氧化碳分压 支撑面 压力性损伤 效果 

分 类 号：R473.6[医药卫生—护理学]