优化目标管理策略对先天性心脏病手术患儿术中压疮的预防效果  

Optimized objective management strategy for the prevention of intraoperative pressure ulcers in children treated with surgeries for congenital heart disease

作　　者：张彦影[1] 邢民者 闫晓丽 张晓曼 刘延芹[1] ZHANG Yanying;XING Minzhe;YAN Xiaoli(Department of Anesthesiology,Hebei Children’s Hospital,Hebei,Shijiazhuang 050031,China;不详)

机构地区：[1]河北省儿童医院麻醉科,石家庄市050031 [2]河北省儿童医院护理部,石家庄市050031 [3]河北省儿童医院新生儿科,石家庄市050031

出　　处：《河北医药》2024年第20期3146-3148,3152,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划项目(编号:ZL20140053)。

摘　　要：目的探讨优化目标管理策略对先天性心脏病手术患儿术中压疮的预防效果。方法选取2021年2月至2022年12月河北省儿童医院行先天性心脏病手术患儿240例,年龄1~60个月,性别不限。采用随机数字表法将其分为传统目标管理组(T组)和优化目标管理组(O组),每组120例。T组目标管理策略包括:完善的风险评估,完善的手术室设备,加强术中护理,对术后压疮进行评估,准确地压疮相关交接班。O组在目标管理策略基础上增加赛肤润的应用和对手术室巡回护士进行短期培训。观察术后即刻(T0)和术后4 h(T1)时不同部位压疮发生率和记录2组护患纠纷率和家属投诉率。结果与T组比较,T0时O组两侧肩胛骨处压疮发生率显著降低(P<0.05);其他部位压疮发生率比较差异无统计学意义(P>0.05);与T组比较,T0和T1时O组压疮发生率显著降低(P<0.05)。结论优化目标管理策略可以有效改善先天性心脏病手术患儿皮肤结局,降低压力性皮肤损伤的发生率,可以为临床优质护理提供依据。Objective To investigate the effect of the optimized objective management strategy on the prevention of intraoperative pressure ulcers in children treated with surgeries for congenital heart disease.Methods A total of 240 male or female children with congenital heart disease,aged 1 to 60 months,were selected from February 2021 to December 2022 in Hebei Children’s Hospital.They were randomly divided into the traditional objective management group(T group)and optimized objective management group(O group),with 120 cases per group.Traditional objective management in T group included the thorough risk assessment,well-developed operating room equipment,enhanced intraoperative nursing care,evaluation of postoperative pressure ulcers,and accurate pressure ulcer-related transition.In O group,application of Sanyrene and short-term training for the operating room itinerant nurses were additionally applied.The incidence of pressure ulcers was observed at the end of surgery(T0)and 4 h after surgery(T1),and nurse-patient dispute rate and the complaint rate of family members were recorded.Results Compared with that of T group,the incidence of pressure ulcers on bilateral scapulae in O group at T0 was significantly decreased(P<0.05),and that on other sites were comparable(P>0.05).Compared with that of T group,the incidence of pressure ulcers at T0 and T1 was significantly lower in O group(P<0.05).Conclusion The optimized objective management strategy can effectively improve the skin outcome of children treated with surgeries for congenital heart disease,reduce the incidence of stress skin injury,and provide evidence for clinical nursing application.

关 键 词：优化目标管理策略 压力性损伤 先心病 小儿 赛肤润 

分 类 号：R726.542[医药卫生—儿科]