50所医院老年患者皮肤损伤现状及危险因素分析  

Analysis on the prevalence and risk factors of skin injuries in the elderly in 50 hospitals in China

作　　者：蒋琪霞 唐永利[2] 洪艳燕[3] 匡丹 王静 展颖颖 潘迎春 高艳红 郝景平 陈锐[10] 刘海燕 俞萍[12] 蔡蕴敏[13] 黄玲 王祖晶 JIANG Qixia;TANG Yongli;HONG Yanyan;KUANG Dan;WANG Jing;ZHAN Yingying;PAN Yingchun;GAO Yanhong;HAO Jingping;CHEN Rui;LIU Haiyan;YU Ping;CAI Yunmin;HUANG Ling;WANG Zujing

机构地区：[1]解放军东部战区总医院烧伤整形科,南京市210002 [2]重庆医科大学附属第一医院骨科 [3]南京市中医院护理部 [4]江南大学附属医院护理部 [5]同济大学附属杨浦医院护理部 [6]解放军东部战区总医院秦淮医疗区门诊部 [7]安徽医科大学附属安庆第一人民医院龙山院区护理部 [8]兴安盟人民医院护理部 [9]宿迁市中医院护理部 [10]九江市第一人民医院医院管理办公室 [11]泗阳县中医院护理部 [12]无锡市第二人民医院重症医学科 [13]复旦大学附属金山医院创面诊疗中心 [14]重庆市秀山县人民医院护理部 [15]苏州市立医院胃肠外科

出　　处：《中华护理杂志》2022年第9期1105-1112,共8页Chinese Journal of Nursing

基　　金：军队卫勤保障能力创新与生成专项课题(20WQ027);上海王正国创伤医学发展基金会课题(WZGF20200101);军队保健专项课题(21BJZ38)。

摘　　要：目的通过多中心横断面调查,分析老年住院患者压力性损伤(pressure injury,PI)、失禁相关性皮炎(incontinence-associated dermatitis,IAD)和皮肤撕裂伤(skin tear,ST)3类皮肤损伤的现患率及危险因素,为预防皮肤损伤提供依据。方法2021年3月31日,来自20个省(区、市)50所医院的1067名护士对所在医院年龄≥60岁的患者进行全身皮肤检查,以判断皮肤损伤发生情况及类型,并收集患者的一般资料、病情资料和有无PI发生危险等资料。使用Logistic回归分析3类皮肤损伤的独立危险因素。结果共调查14470例老年住院患者,年龄为(73.35±8.90)岁,皮肤损伤总现患率为6.69%,PI、IAD、ST的现患率分别为3.91%、1.89%和0.89%。Logistic回归分析显示,有PI发生危险、协助自理、低蛋白血症、汉族、贫血、慢性病数量≥2种和年龄≥71岁为老年住院患者发生PI的独立危险因素;有PI发生危险、协助自理、低蛋白血症、慢性病数量≥2种、住院时间≥8 d和年龄>80岁为IAD的独立危险因素;有PI发生危险、低蛋白血症为ST的独立危险因素(均P<0.05)。结论老年住院患者3类皮肤损伤均为多因素综合作用的结果,不同类型皮肤损伤的危险因素不尽相同。制订预防策略时既要关注危险因素的独立作用,也要考虑其联合作用,采取综合预防措施,以提高预防效果。Objective To analyze the prevalence and risk factors of 3 types of skin injuries in the elderly through multicenter cross-sectional survey,so as to provide bases for formulating prevention strategies for skin injuries in the elderly.Methods On March 31,2021,1067 nurses from 50 hospitals in 16 provinces,2 autonomous regions and 2 municipalities included inpatients over 60 years old and inspected their skin from head to toes to identify pressure injury(PI),incontinence-associated dermatitis(IAD)and skin tear(ST),and meanwhile collected demographic,healthcare condition and PI risk assessment data.Statistical software was used for descriptive analysis,Pearson correlation analysis and logistic regression analysis.Results Totally,14470 cases were obtained.The average age was(73.35±8.90)years old.The total prevalence of skin injuries was 6.69%,and the prevalence of PI,IAD and ST was 3.91%,1.89%and 0.89%,respectively.Logistic regression analysis showed that the risk of PI,inability of self-care,hypoproteinemia and anemia,comorbidity over 2 chronic diseases and≥70 years old were the independent risk factors of PI in the elderly.The risk of PI,inability of self-care,hypoproteinemia,comorbidity over 2 chronic diseases,length of hospital stay≥8 days and the age of over 80 years were the independent risk factors of IAD in the elderly.The risk of PI and hypoproteinemia were independent risk factors of ST in the elderly.Conclusion Skin injuries of the hospitalized elderly are the result of multiple factors,while PI and IAD are the most typical ones,and the risk factors of different types of skin injuries are also different.When formulating prevention strategies,we should not only pay attention to the independent role of risk factors,but also consider the combined role of risk factors,take comprehensive preventive measures to improve the prevention effect.

关 键 词：伤口和损伤 老年人 横断面调查 危险因素 多中心研究 护理 

分 类 号：R472[医药卫生—护理学]