曲线仰卧位对组织界面压力的影响：一项前瞻性前后对照研究。

Effects of Curvilinear Supine Position on Tissue Interface Pressure: A Prospective Before-and-After Study.

作者信息

Guo Yue, Li Yan, Zhao Kuaile, Yue Xiao, Yu Yunhong, Kuang Wan, Liu Jing, Li Xiangyan, Zhao Tiyu

机构信息

Yue Guo, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Yan Li, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Kuaile Zhao, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Xiao Yue, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Yunhong Yu, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Wan Kuang, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Jing Liu, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Xiangyan Li, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China. Tiyu Zhao, MD, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology.

出版信息

J Wound Ostomy Continence Nurs. 2017 Sep/Oct;44(5):450-454. doi: 10.1097/WON.0000000000000360.

DOI:10.1097/WON.0000000000000360

PMID:28877111

Abstract

PURPOSE

To determine whether a curvilinear supine position increases the contact area between the subject and the surgical table, reduces interface pressures within contact areas, and improves comfort.

DESIGN

This observational study was completed to establish proof-of-concept to determine differences between 2 positions (supine and curvilinear) on interface pressure of 5 at-risk anatomical locations, overall contact area, and subjects' comfort level.

SUBJECTS AND SETTING

The study was conducted at the operating theater of a tertiary teaching hospital in Wuhan, China. The sample comprised 145 healthy Asian volunteers between 18 and 60 years of age.

METHODS

Subjects were placed in the supine and curvilinear supine positions on a surgical table. Contact area and peak interface pressures of 5 at-risk anatomical locations (occiput, scapula, sacrum, calf, and heel) were measured using a pressure mapping system, and the mean and maximum pressures of the overall contact area were calculated. Comfort was assessed by self-report using a Likert scale of 1 to 5. The Wilcoxon paired signed rank test was used to compare differences between the 2 positions, and the Spearman correlation analysis was used to identify associations among outcome variables.

RESULTS

Results indicated that whole-body (overall) maximum, average interface pressures, and maximum interface pressures of the sacrum and the heel were decreased significantly, with contact area and comfort-level score increasing from 2438.71 to 2709.68 cm and 3.00 to 4.00, respectively (P < .001). Statistically significant associations were found between the contact area and measures of body morphology; correlation coefficients varied from 0.409 to 0.740 (P < .001).

CONCLUSIONS

Curvilinear supine position increased overall contact area with the support surface, reduced interface pressures over contact areas (bony prominences), improved comfort, and enhanced pressure redistribution. Additional research is needed to determine if these effects will reduce intraoperative pressure injury occurrence.

摘要

目的

确定曲线仰卧位是否能增加受试者与手术台之间的接触面积，降低接触区域内的界面压力，并提高舒适度。

设计

本观察性研究旨在建立概念验证，以确定两种体位（仰卧位和曲线仰卧位）在5个高风险解剖部位的界面压力、总体接触面积和受试者舒适度水平方面的差异。

受试者与研究环境

该研究在中国武汉一家三级教学医院的手术室进行。样本包括145名年龄在18至60岁之间的健康亚洲志愿者。

方法

将受试者置于手术台上的仰卧位和曲线仰卧位。使用压力映射系统测量5个高风险解剖部位（枕部、肩胛骨、骶骨、小腿和足跟）的接触面积和峰值界面压力，并计算总体接触面积的平均压力和最大压力。通过使用1至5的李克特量表进行自我报告来评估舒适度。采用Wilcoxon配对符号秩检验比较两种体位之间的差异，并采用Spearman相关分析确定结果变量之间的关联。

结果

结果表明，全身（总体）最大、平均界面压力以及骶骨和足跟的最大界面压力均显著降低，接触面积和舒适度评分分别从2438.71平方厘米增加到2709.68平方厘米，从3.00提高到4.00（P < .001）。在接触面积与身体形态测量指标之间发现了具有统计学意义的关联；相关系数在0.409至0.740之间（P < .001）。