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红外热成像技术在压力性损伤预警中的应用:一项前瞻性观察研究。

Application of infrared thermography in the early warning of pressure injury: A prospective observational study.

机构信息

School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China.

School of Nursing, Wenzhou Medical University, Wenzhou, China.

出版信息

J Clin Nurs. 2021 Feb;30(3-4):559-571. doi: 10.1111/jocn.15576. Epub 2021 Jan 26.

Abstract

AIMS AND OBJECTIVES

To verify the ability of infrared thermography in objectively identifying pressure injury and its application value in the early warning of pressure injury.

BACKGROUND

There is subjectivity in assessing the risk of pressure injury as well as diagnosis in clinical settings, which makes early detection and prevention difficult.

DESIGN

Prospective, cohort study.

METHOD

Four hundred and fifteen patients admitted to the adult intensive care units were enrolled by a convenience sampling method, and they received a follow-up monitoring for 10 days. The risk of pressure injury was assessed via Braden scale, and thermal images of sacral area were obtained by infrared thermal imager once a day. The predictive effects of infrared thermography and Braden scale on pressure injury were compared by the receiver operating characteristic curve from which the optimal cut-off value of skin temperature for predicting pressure injury was determined. The effect of skin temperature on pressure injury was described and compared, using Kaplan-Meier curve and Cox proportional hazard regression model, respectively. We followed STROBE checklist for reporting the study.

RESULTS

The relative temperature of sacral area was negatively correlated with the risk of pressure injury. The efficiency of infrared thermography for diagnosing pressure injury was better than that of Braden scale. Based on the relative temperature optimal cut-off value (-0.1°C), Kaplan-Meier curve and Cox proportional hazard regression model analysis showed the incidence of pressure injury with relative temperature below -0.1°C was higher than the group with relative temperature above -0.1°C.

CONCLUSIONS

Infrared thermography can objectively and accurately identify local hypothermia warnings of pressure injury before visual recognition. The application of infrared thermography into routine pressure injury risk assessment provides a timely and reliable method for nursing practitioners.

RELEVANCE TO CLINICAL PRACTICE

Infrared thermography has great value of clinical application in daily pressure injury assessment. It is of great significance to make a faster and more objective clinical judgement for patients at risk of pressure injury.

摘要

目的

验证红外热成像技术客观识别压力性损伤的能力及其在压力性损伤预警中的应用价值。

背景

临床评估压力性损伤风险和诊断存在主观性,这使得早期检测和预防变得困难。

设计

前瞻性队列研究。

方法

采用便利抽样法,选取 415 名入住成人重症监护病房的患者进行随访监测 10 天。采用 Braden 量表评估压力性损伤风险,每天使用红外热像仪获取骶尾部热像图。通过受试者工作特征曲线比较红外热成像和 Braden 量表对压力性损伤的预测效果,确定预测压力性损伤的皮肤温度最佳截断值。采用 Kaplan-Meier 曲线和 Cox 比例风险回归模型分别描述和比较皮肤温度对压力性损伤的影响。本研究按照 STROBE 清单进行报告。

结果

骶尾部相对温度与压力性损伤风险呈负相关。红外热成像诊断压力性损伤的效率优于 Braden 量表。基于相对温度最佳截断值(-0.1°C),Kaplan-Meier 曲线和 Cox 比例风险回归模型分析显示,相对温度低于-0.1°C的患者发生压力性损伤的风险高于相对温度高于-0.1°C的患者。

结论

红外热成像技术可在视觉识别之前客观、准确地识别压力性损伤局部低体温预警。将红外热成像应用于常规压力性损伤风险评估可为护理人员提供及时、可靠的方法。

临床意义

红外热成像在日常压力性损伤评估中具有重要的临床应用价值。它对于压力性损伤风险患者的快速、客观的临床判断具有重要意义。

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