老年患者皮肤撕裂伤流行特征及危险因素的多中心横断面研究  

A multicenter, cross-sectional study on prevalence, characteristics and risk factors of skin tears in elderly patients

作　　者：蒋琪霞 唐永利[2] 展颖颖 王学红 赵静[5] 张燕双 索惠娟 李冬梅 李霞 蔡蕴敏[10] 黄玲 庞建喜 杨海燕 窦薇[14] 张晓蓉 Jiang Qixia;Tang Yongli;Zhan Yingying;Wang Xuehong;Zhao Jing;Zhang Yanshuang;Suo Huijuan;Li Dongmei;Li Xia;Cai Yunmin;Huang Ling;Pang Jianxi;Yang Haiyan;Dou Wei;Zhang Xiaorong(Department of Burns and Plastic Surgery,Eastern Theater General Hospital of PLA,Nanjing 210002,China)

机构地区：[1]中国人民解放军东部战区总医院烧伤整形科,江苏南京210002 [2]重庆医科大学附属第一医院骨科 [3]中国人民解放军东部战区总医院秦淮医疗区门诊部 [4]南京鼓楼医院集团宿迁医院护理部 [5]江苏省人民医院门诊治疗室 [6]常熟第二人民医院护理部 [7]邳州市人民医院普外科 [8]广西壮族自治区桂东人民医院伤口造口失禁护理门诊 [9]芜湖市第五人民医院伤口造口门诊 [10]复旦大学附属金山医院创面诊疗中心 [11]重庆市秀山县人民医院护理部 [12]宜兴市第二人民医院门诊部 [13]三明市第一医院胸心血管外科 [14]云南省第一人民医院老年科 [15]重庆医科大学附属第一医院青杠老年护养中心护理院

出　　处：《护理学杂志》2022年第5期34-37,共4页Journal of Nursing Science

基　　金：上海王正国创伤医学发展基金会课题(WZGF20200101);军队卫勤保障能力创新与生成专项课题(20WQ027)。

摘　　要：目的调查分析我国不同医疗机构老年患者皮肤撕裂伤的流行特征及危险因素,为有效预防老年皮肤撕裂伤提供参考。方法招募16个省、2个自治区和2个直辖市52所医院或养老院,整群抽取≥60岁的住院患者,从头到脚检查纳入对象的皮肤识别是否存在皮肤撕裂伤及其严重度,并收集人口学、健康状况以及皮肤撕裂伤致伤原因等相关资料。结果共获得14675例有效资料,发现皮肤撕裂伤129例,现患率0.88%;康复医院皮肤撕裂伤现患率最高(0.97%),其次为综合性医院(0.90%)、老年医院(0.49%),养老院为0。前三位致伤原因为跌倒(27.13%)、钝力创伤(24.03%)和移除粘性敷料(17.83%)。回归分析显示,有皮肤撕裂伤发生史、有压力性损伤发生风险是老年患者皮肤撕裂伤的危险因素(OR=230.240、4.050)。结论老年皮肤撕裂伤常见致伤原因为跌倒、钝力创伤和移除粘性敷料;最近6个月内有皮肤撕裂伤发生史和压力性损伤发生风险是独立危险因素。需根据危险因素构建简便易行和具有良好预测效度的预测工具。Objective To explore the prevalence,characteristics and risk factors of skin tears in elderly patients in different medical institutions in China,so as to provide reference for effective prevention of skin tear in the elderly.Methods Fifty-two hospitals or elderly care institutions were recruited from 16 provinces,2 autonomous regions and 2 municipalities directly under the central go-vernment in China.Then patients aged 60 years and older in these institutions were selected by cluster sampling and received head-to-toe assessment of skin integrity,and their demographic data,health status and skin tear data were also collected.Results A total of 14,675 patients were eligible and 129 of them had skin tears,with a prevalence rate of 0.88%.The prevalence of skin tear in rehabilitation hospitals was the highest(0.97%),followed by general hospitals(0.90%),geriatric hospitals(0.49%)and nursing homes(0).The main contributory factors for skin tear were found to be outcome of a fall(27.13%),blunt trauma(24.03%)and removal of adhesive dressings(17.83%).The results of logistic regression analysis showed that skin tear history and pressure injury risk(Braden score≤16)were risk factors for skin tears in elderly patients(OR=230.240 and 4.050).Conclusion The common causes of skin tear in elderly patients are fall,blunt trauma and removal of adhesive dressing.Skin tear history in the last 6 months and pressure injury risk are independent risk factors.It is necessary to build a simple and practical measure with acceptable predictive validity according to the risk factors.

关 键 词：老年人 皮肤撕裂伤 压力性损伤 跌倒 皮肤干燥 自理能力 粘性敷料 危险因素 

分 类 号：R473.6[医药卫生—护理学]