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基于卧床操作期间剪切力和压力导致压疮发展的机制:体型、体位和膝盖位置的影响。

Mechanism leading to the development of pressure ulcers based on shear force and pressures during a bed operation: influence of body types, body positions, and knee positions.

机构信息

Research and Development Department, Healthcare Products Division, Molten Corporation, Hiroshima, Japan.

出版信息

Wound Repair Regen. 2009 Nov-Dec;17(6):789-96. doi: 10.1111/j.1524-475X.2009.00540.x. Epub 2009 Oct 12.

Abstract

Surface pressures and shear forces were measured in order to clarify the mechanism leading to the development of a pressure ulcer at five sites on the body during the operation of a bed (bed) using a device for simultaneously measuring pressure and shear force. Changes of shear force and pressure when three body types adopted different supine positions, with or without raising/bending the knees (raising the knees), were investigated and analyzed. The results are as follows: a slender body type tends to have the highest shear force at the coccygeal bone site and also has a higher surface pressure at the coccygeal and at the lateral sacral bone sites than an obese body type. On the other hand, an obese body type has a higher surface pressure at the other sites than the slender type. Shear forces at the sacrum and coccygeal bone sites can be reduced during a bed operation by raising the knees. Furthermore, shear forces can be reduced during a bed operation in a supine position by matching the body's bending points with those of the bed or by shifting the subjects 10 cm toward the head of the bed. These new findings are clinically useful in the treatment and the prevention of the onset of pressure ulcers.

摘要

为了阐明导致卧床患者身体五个部位发生压疮的机制,我们使用一种可同时测量压力和剪切力的设备,对卧床患者身体五个部位的表面压力和剪切力进行了测量。研究和分析了三种体型在不同仰卧位、屈膝或不屈膝(抬高膝盖)时剪切力和压力的变化。结果如下:瘦体型在尾骨部位的剪切力最高,尾骨和骶骨外侧部位的表面压力也高于肥胖体型。另一方面,肥胖体型在其他部位的表面压力高于瘦体型。抬高膝盖可降低骶骨和尾骨部位的剪切力。此外,通过使身体的弯曲点与床的弯曲点相匹配或使受试者向床头方向移动 10 厘米,可在仰卧位时降低剪切力。这些新发现对于压疮的治疗和预防具有重要的临床意义。

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