ICU患者气管插管相关压力性损伤发生现状及影响因素分析  

Current status and influencing factors of endotracheal intubation-related pressure injury in ICU patients

作　　者：王志伟 任佳乐 何小燕 骆春兰 悦云 陈莉 朱娅婷 董正惠 Wang Zhiwei;Ren Jiale;He Xiaoyan;Luo Chunlan;Yue Yun;Chen Li;Zhu Yating;Dong Zhenghui(Department of Critical Care Medicine,The Fifth People's Hospital of Qinghai Province,Xining 810000,China)

机构地区：[1]青海省第五人民医院重症医学科,青海西宁810000 [2]新疆医科大学第一附属医院急诊重症医学科 [3]青海省第五人民医院肿瘤内二科 [4]青海省第五人民医院护理部 [5]新疆医科大学第六附属医院护理部

出　　处：《护理学杂志》2024年第20期69-73,共5页Journal of Nursing Science

基　　金：新疆护理学会资助项目(2023XH026)。

摘　　要：目的探究ICU患者气管插管相关压力性损伤的发生特征,分析其影响因素。方法选取入住ICU的713例留置气管插管患者,根据是否发生气管插管相关压力性损伤将其分为损伤组(n=290)和未损伤组(n=423),比较两组临床资料及气管插管相关资料,采用logistic回归分析ICU患者气管插管相关压力性损伤的影响因素。结果290例患者发生气管插管相关压力性损伤,发生率为40.67%。logistic回归分析显示,APACHEⅡ评分、白细胞介素-6、俯卧位通气、镇痛、气管插管留置时间是ICU患者发生气管插管相关压力性损伤的危险因素,皮肤潮湿度低及较高水平的血清白蛋白是保护因素(均P<0.05)。构建的logistic回归模型拟合度良好,内部验证发现ROC曲线下面积为0.948(95%CI:0.933~0.963)。结论ICU患者气管插管相关压力性损伤发生率较高,临床应重视其影响因素并制订针对性干预措施,以降低气管插管相关压力性损伤的发生。Objective To explore the characteristics of endotracheal intubation-related pressure injury in ICU patients,and to analyze its influencing factors.Methods A total of 713 ICU patients with indwelling tracheal intubation were selected,and they were divided into an injury group(n=290)and a non-injury group(n=423)according to whether tracheal intubation-related PI occurred.The clinical data and endotracheal intubation-related data were compared between the two groups.Logistic regression was used to analyze the influencing factors of endotracheal intubation-related pressure injury in ICU patients.Results Endotracheal intubation-related PI occurred in 290 patients,with an incidence of 40.67%.Logistic regression analysis showed that APACHEⅡscore,interleukin-6,prone ventilation,analgesia,and duration of endotracheal intubation were risk factors for endotracheal intubation-related PI in ICU patients,and lower degree of skin humidity and higher serum albumin levels were protective factors(all P<0.05).The constructed logistic regression model had an AUC=0.948(95%CI:0.933-0.963),and good model fit.Conclusion The incidence of endotracheal intubation-related PI in ICU patients is high,and clinical attention should be paid to its influencing factors and targeted interventions should be formulated to reduce the incidence of endotracheal intubation-related PI.

关 键 词：重症监护室 气管插管 压力性损伤 俯卧位通气 镇痛 皮肤潮湿 血清白蛋白 影响因素 

分 类 号：R471[医药卫生—护理学]