老年晚期肺癌合并呼吸衰竭气管插管患者院内压疮风险的相关危险因素调查  

Investigation of risk factors related to hospital pressure ulcer in elderly patients with advanced lung cancer complicated with respiratory failure and tracheal intubation

作　　者：杨慧 王甜甜 庞海燕 YANG Hui;WANG Tiantian;PANG Haiyan(Department of Respiratory and Critical Care Medicine,Nanyang Central Hospital,Nanyang,Henan473000,China)

机构地区：[1]南阳市中心医院呼吸与危重症医学科一病区,河南南阳473000

出　　处：《社区医学杂志》2023年第21期1142-1146,共5页Journal Of Community Medicine

摘　　要：目的分析老年晚期肺癌合并呼吸衰竭气管插管患者院内皮肤压力性损伤风险的相关危险因素,以期为临床早期防治提供依据。方法选取2020-06-01-2022-12-31南阳市中心医院收治的295例老年晚期肺癌合并呼吸衰竭气管插管患者作为研究对象,根据是否发生院内皮肤压力性损伤将患者分为发生组(n=39)和未发生组(n=256)。利用调查问卷方式收集2组临床资料,通过SPSS 22.0软件进行一般资料对比,利用logistic回归模型分析发生院内皮肤压力性损伤的影响因素。结果发生组年龄≥70岁占比58.97%(23/39)、感染占比61.54%(24/39)、鼻胃管喂养占比58.97%(23/39)、气管切开占比56.41%(22/39)、机械通气时间>5d占比69.23%(27/39)、强迫体位占比28.21%(11/39)分与未发生组35.94%(92/256)、29.69%(76/256)、27.73%(71/256)、33.59%(86/256)、40.63%(104/256)、10.55%(27/256)相比明显升高,差异有统计学意义,χ^(2)值分别为7.551、15.323、15.213、7.592、11.218、8.100,均P<0.05;Braden评分(14.75±3.02)分与未发生组(17.18±2.11)分相比明显减少,t=6.286,P<0.05;logistic回归分析显示,年龄≥70岁(OR=5.168,95%CI:1.856~14.392)、感染(OR=9.886,95%CI:5.628~17.364)、鼻胃管喂养(OR=6.348,95%CI:2.075~19.418)、气管切开(OR=7.241,95%CI:3.481~15.062)、机械通气时间>5d(OR=5.960,95%CI:1.927~18.436)、强迫体位(OR=6.650,95%CI:2.695~16.411)是老年晚期肺癌合并呼吸衰竭气管插管患者发生院内皮肤压力性损伤的危险因素,Braden评分>16.86分(OR=0.171,95%CI:0.043~0.681)是老年晚期肺癌合并呼吸衰竭气管插管患者发生院内皮肤压力性损伤的保护因素,P<0.05。结论年龄(≥70岁)、感染、鼻胃管喂养、气管切开、机械通气时间(>5d)、Braden评分(>16.86分)为老年晚期肺癌患者合并呼吸衰竭气管插管患者发生院内皮肤压力性损伤的影响因素,临床可针对性制定干预措施以预防皮肤压力性损伤。Objective To analyze the risk factors related to nosocomial skin pressure injury in elderly patients with advanced lung cancer complicated with respiratory failure and tracheal intubation,in order to provide evidence for early clinical prevention and treatment.Methods Totally 295patients with advanced lung cancer complicated with respiratory failure and tracheal intubation admitted to Nanyang Central Hospital from 2020-06-01to 2022-12-31were selected as the study objects.According to whether they had nosocomial skin pressure injury,the patients were divided into occurrence group(n=39)and non-occurrence group(n=256).The clinical data of the two groups were collected by means of questionnaire,the general data were compared by SPSS 22.0software,and the influencing factors of hospital skin stress injury were analyzed by Logistic regression model.Results In the occurrence group,58.97%(23/39)were≥70years old,61.54%(24/39)were infected,58.97%(23/39)were fed by nasogassive tube,56.41%(22/39)were tracheotomy,69.23%(27/39)were mechanically ventilated for more than 5days,28.21%(11/39)were forced position,the percentage of which were significantly higher than those of the non-occurrence group 35.94%(92/256),29.69%(76/256),27.73%(71/256),33.59%(86/256),40.63%(104/256),10.55%(27/256)(χ^(2)=7.551,15.323,15.213,7.592,11.218,8.100,all P<0.05),and Braden score(14.75±3.02)was significantly lower than that in the non-occurrence group(17.18±2.11),t=6.286,P<0.05.Logistic regression analysis showed that age≥70years(OR:5.168,95%CI:1.856-14.392),infection(OR=9.886,95%CI:5.628-17.364),nasogastric tube feeding(OR=6.348,95%CI:2.075-19.418),tracheotomy(OR=7.241,95%CI:3.481-15.062),mechanical ventilation time>5days(OR=5.960,95%CI:1.927-18.436),forced position(OR=6.650,95%CI:2.695-16.411)was risk factors for hospital skin stress injury in elderly patients with advanced lung cancer combined with respiratory failure and tracheal intubation.Braden score>16.86(OR=0.171,95%CI:0.043-0.681)was a protective factor for nosocomial skin pressure i

关 键 词：晚期肺癌 呼吸衰竭 气管插管 院内皮肤压力性损伤 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]