先天性小耳畸形外耳再造手术患者对侧耳郭压力性损伤发生的影响因素分析  

Analysis of influencing factors of contralateral auricular operative acquired pressure injury in patients undergoing external ear reconstruction for congenital microtia

作　　者：刘元菲 李亚男 宋杰 刘娜 LIU Yuanfei;LI Yanan;SONG Jie;LIU Na(Department of Central Operating Room,Plastic Surgery Hospital of Chinese Academy of Medical Science,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院中心手术室,北京100144 [2]中国医学科学院北京协和医学院整形外科医院护理部,北京100144

出　　处：《中国美容整形外科杂志》2025年第2期105-108,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的分析先天性小耳畸形外耳再造手术患者对侧耳郭压力性损伤的影响因素,为术中压力性损伤的预防提供依据。方法选取自2022年1月至2023年12月,中国医学科学院北京协和医学院整形外科医院手术室用病例对照研究设计,按照1∶2匹配原则选取1905例小耳畸形外耳再造手术的患者作为调查对象,病例组为对侧耳郭发生压力性损伤的小耳畸形外耳再造手术患者(25例),对照组为匹配同一时间段未发生压力性损伤的患者(50例),分析可能导致对侧耳郭压力性损伤发生的因素。结果1905例小耳畸形外耳再造手术患者中25例(1.3%)发生对侧耳郭压力性损伤,其中一期压力性损伤有22例,二期3例。单因素结果显示是否低体温(<36℃)、不同手术时间、总白蛋白、白蛋白、前白蛋白及出血量情况的手术患者术中压力性损伤的发生率差异有统计学意义(P<0.05),多因素分析结果显示有低体温、手术时间≥3 h、出血量≥50 ml及前白蛋白下降差异有统计学意义(P<0.05)。结论先天性小耳畸形外耳再造手术患者对侧耳郭发生术中压力性损伤的危险因素较多,术中低体温、手术时间较长、出血量较多及前白蛋白下降的患者应作为重点监控对象,进一步研究定制专项干预措施,以降低小耳畸形外耳再造手术患者对侧耳压力性损伤的发生率,保证患者安全,提高手术室护理质量。Objective To analyze the influencing factors of contralateral auricular intraoperative acquired pressure injury in patients undergoing external ear reconstruction for congenital microtia,and to provide basis for the prevention of intraoperative acquired pressure injury.Methods From January 2022 to December 2023,a matched case-control study was conducted.All 1905 cases,the matching rule is 1∶2.The 25 patients with contralateral auricle intraoperative acquired pressure injury after ear reconstruction surgery were as the case group and 50 patients without intraoperative acquired pressure injury as the control group.Then patients'medical records were reviewed to identify risk factors of contralateral auricle intraoperative acquired pressure injury.Results Totally 1905 patients were selected.There were 25(1.3%)patients had intraoperative acquired pressure injury,among which 22 had stage 1 pressure injury,3 had stage 2 pressure injury.There were significant differences between hypothermia,surgery time,total albumin,albumin,prealbumin,bleeding volume in univariate analysis(P<0.05).In multi-factor analysis,hypothermia,surgery time≥3 hours,bleeding volume≥50 milliliters and prealbumin decreased had a significant effect(P<0.05).Conclusion There are more risk factors for intraoperative acquired pressure injury of contralateral auricle in patients undergoing external ear reconstruction.Patients with intraoperative hypothermia,long surgery time,large amount of blood loss and decreased prealbumin should be focused.The preventive strategies need to be applied for the high risk patients in order to reduce the incidence of pressure injury,ensure the safety of the patients and improve the quality of nursing in the operation room.

关 键 词：小耳畸形 外耳再造手术 压力性损伤 影响因素 

分 类 号：R47[医药卫生—护理学]