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接受消化系统手术患者术中压力性损伤的危险因素:一项回顾性研究。

Risk factors for intraoperative pressure injuries in patients undergoing digestive surgery: A retrospective study.

机构信息

Operation Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Clin Nurs. 2019 Apr;28(7-8):1148-1155. doi: 10.1111/jocn.14712. Epub 2018 Dec 7.

Abstract

AIM AND OBJECTIVE

To investigate the incidence of intraoperative blanchable erythema and pressure injuries in patients undergoing digestive surgery and to explore potential risk factors.

BACKGROUND

Pressure injuries pose significant economic and healthcare burden to patients and are used as one of the key indicators of nursing in the operation room with high incidence.

DESIGN

A retrospective observational study.

METHODS

Basic information and the results of 3S intraoperative risk assessment scale of pressure injury were obtained from the information system. And the patients with intraoperative blanchable erythema or pressure injuries were followed up for 72 hr by the information system. The clinical data were collected to analyse risk factors for intraoperative blanchable erythema and pressure injuries by univariate analysis and logistic regression analysis. STROBE checklist for cohort studies was applied in the preparation of the paper.

RESULTS

Of 5,136 surgical cases, 134 (2.61%) had blanchable erythema, 37 (0.72%) had intraoperative pressure injuries, and 8 (0.16%) had pressure injuries at 72-hr follow-up. Preoperative skin under compression, preoperative physical activity, surgical position and extra intraoperative pressure were considered independent risk factors for intraoperative pressure injuries.

CONCLUSION

The incidence of pressure injuries in our study was lower than those reported in the previous studies. Accessing preoperative skin under compression, preoperative physical activity, surgical position and extra intraoperative pressure was considered to be significant for preventing pressure injuries.

RELEVANCE TO CLINICAL PRACTICE

The findings suggest that preoperative skin under compression, preoperative physical activity, surgical position and extra intraoperative pressure are associated with intraoperative pressure injuries in patients undergoing digestive surgery.

摘要

目的和目标

调查接受消化手术患者术中可褪色红斑和压力性损伤的发生率,并探讨潜在的危险因素。

背景

压力性损伤给患者带来了巨大的经济和医疗负担,并且作为手术室护理的关键指标之一,其发生率较高。

设计

回顾性观察性研究。

方法

从信息系统中获取基本信息和 3S 术中压力性损伤风险评估量表的结果。通过信息系统对术中出现可褪色红斑或压力性损伤的患者进行 72 小时的随访。收集临床资料,采用单因素分析和逻辑回归分析对术中可褪色红斑和压力性损伤的危险因素进行分析。本研究按照 STROBE 队列研究清单进行报告。

结果

在 5136 例手术病例中,134 例(2.61%)出现可褪色红斑,37 例(0.72%)出现术中压力性损伤,8 例(0.16%)在 72 小时随访时出现压力性损伤。术前受压皮肤、术前体力活动、手术体位和术中额外压力被认为是术中压力性损伤的独立危险因素。

结论

本研究中压力性损伤的发生率低于以往研究报道。评估术前受压皮肤、术前体力活动、手术体位和术中额外压力有助于预防压力性损伤。

临床意义

研究结果表明,术前受压皮肤、术前体力活动、手术体位和术中额外压力与接受消化手术患者的术中压力性损伤有关。

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