三种压力性损伤评估量表对ICU体外循环术后患者压力性损伤预测能力比较  

Comparison of three pressure injury assessment scales for predicting pressure injury in patients after cardiopulmonary bypass in ICU

作　　者：李振刚 王亚婷 祁进芳 董正惠 LI Zhengang;WANG Yating;QI Jinfang;DONG Zhenghui(Department of Critical Care Medicine,Xinjiang Medical University Affiliated First Hospital,Xinjiang Uygur Autonomous Region,Urumqi 830092,China;Vocational and Technical School,Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Kuerle 841000,China;Nursing School,Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830092,China;Department of Nursing,Xinjiang Medical University Affiliated Sixth Hospital,Xinjiang Uygur Autonomous Region,Urumqi 830092,China)

机构地区：[1]新疆医科大学第一附属医院重症医学中心,新疆乌鲁木齐830092 [2]新疆医科大学高等职业技术学院,新疆库尔勒841000 [3]新疆医科大学护理学院,新疆乌鲁木齐830092 [4]新疆医科大学第六附属医院护理部,新疆乌鲁木齐830092

出　　处：《中国医药导报》2022年第9期50-54,共5页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金资助项目(2021D01C455)。

摘　　要：目的通过比较Braden、COMHON、Cubbin&Jackson三种量表对重症监护病房(ICU)体外循环术后患者压力性损伤的预测效果,筛选此类患者压力性损伤风险最佳预测工具。方法运用Braden量表、COMHON量表、Cubbin&Jackson量表对2017年9月至2019年2月入住某三级甲等医院252例ICU体外循环术后患者进行压力性损伤风险评估,比较三种量表对7 d内发生的压力性损伤的预测能力。结果252例体外循环术后ICU患者中,150例患者在7 d内发生压力性损伤,102例患者未发生压力性损伤。两组疾病类型、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、机械通气时间比较,差异有统计学意义(P<0.05)。三种量表预测能力比较:Braden量表预测ICU体外循环术后患者压力性损伤发生的临界值为10分,受试者工作特征曲线下面积(AUC)、灵敏度、特异度、阳性似然比、阴性似然比分别为0.512、29.33%、74.51%、1.149、0.948和0.523;COMHON量表预测ICU体外循环术后患者压力性损伤发生的临界值为17分,其AUC、灵敏度、特异度、阳性似然比、阴性似然比分别为0.523、30.67%、80.39%、1.564、0.862;Cubbin&Jackson量表预测ICU体外循环术后患者压力性损伤发生的临界值为25分,其AUC、灵敏度、特异度、阳性似然比、阴性似然比分别为0.687、64.67%、64.71%、1.837、0.546。两组强心药维度得分比较,差异有统计学意义(P<0.05)。结论Cubbin&Jackson量表较Braden量表及COMHON量表更适用于预测ICU体外循环术后患者的压力性损伤。Objective To compare the predictive effects of Braden,COMHON,Cubbin&Jackson scales on pressure injury in intensive care unit(ICU)patients after cardiopulmonary bypass,and to screen the best predictive tool for pressure injury risk in such patients.Methods The Braden scale,COMHON scale,and Cubbin&Jackson scale were used to assess the risk of pressure injury in 252 patients admitted to a tertiary hospital after cardiopulmonary bypass from September 2017 to February 2019.The predictive power of the three scales for pressure injury occurring within seven days was compared.Results Among 252 ICU patients after cardiopulmonary bypass,150 patients developed pressure injury within seven days,and 102 patients did not develop pressure injury.There were significant differences in disease type,acute physiology and chronic health evaluationⅡscore and mechanical ventilation time between the two groups(P<0.05).Comparison of the predictive ability of the three scales:the Braden scale for predicting the occurrence of pressure injury in patients after cardiopulmonary bypass in the ICU with a critical value of 10 points,the area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and positive likelihood ratio,the negative likelihood ratios were 0.512,29.33%,74.51%,1.149,0.948,and 0.523;the critical value of COMHON scale for predicting the occurrence of pressure injury in patients after cardiopulmonary bypass in ICU was 17 points,and its AUC,sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio were 0.523,30.67%,80.39%,1.564,0.862,respectively;the critical value of the Cubbin&Jackson scale for predicting the occurrence of pressure injury in patients after cardiopulmonary bypass in the ICU was 25 points,and its AUC,sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio were 0.687,64.67%,64.71%,1.837,0.546.There was a statistically significant difference in the scores of inotropic drugs between the two groups(P<0.05).Conclusion The Cubbin&Jackson scale in m

关 键 词：压力性损伤 COMHON量表 Cubbin&Jackson量表 BRADEN量表 重症监护室 体外循环 

分 类 号：R47[医药卫生—护理学]