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呼吸重症监护病房中社区获得性肺炎患者院外诱发应激损伤的发生特征及影响因素分析

Analysis of Occurrence Characteristics and Influencing Factors of Out-of-Hospital Induced Stress Injury in Patients with Community-Acquired Pneumonia in Respiratory Intensive Care Unit.

作者信息

Zhang Changmin, Ma Jinliang, Hao Junping

机构信息

Respiratory and Critical Care, Medicine Division, Qilu Hospital, Shandong University, Shandong, China.

出版信息

Iran J Public Health. 2022 Mar;51(3):562-568. doi: 10.18502/ijph.v51i3.8932.

Abstract

BACKGROUND

We aimed to evaluate the characteristics of a stress injury in community-acquired pneumonia (CAP) patients in the respiratory intensive care unit (RICU) and analyze the risk factors, to provide evidence for clinical prevention and treatment.

METHODS

This retrospective study was conducted in RICU at Qilu Hospital of Shandong University, China. We selected 85 patients with traumatic CAP who were brought in from January 2019 to December 2020 as the case group and 167 patients without traumatic CAP hospitalized in the same period as the control group. Multivariate binary Logistic regression analysis was used to explore the influencing factors.

RESULTS

The incidence rate of a stress injury in 252 patients was 33.73%. The most affected region found in these patients was the sacrococcygeal region (24.26%). Most of the patients were presented in stage one (49.50%). Factors associated with a stress-induced injury in RICU, CAP patients were CURB-65 combined with cerebrovascular disease, fever combined with heart disease and albumin was found as an independent risk factor.

CONCLUSION

Attempts to improve stress injury in CAP patients through setting measurable process of care standards are to be encouraged. An approach including the patient's clothes and bedding should be changed frequently, nutrition should be managed and the skin of the patient should be kept clean and dry. The occurrence of stress can further be reduced by the use of protective tools and the timely participation of the family members in patient management.

摘要

背景

我们旨在评估呼吸重症监护病房(RICU)中社区获得性肺炎(CAP)患者应激性损伤的特征并分析危险因素,为临床防治提供依据。

方法

本回顾性研究在山东大学齐鲁医院RICU进行。选取2019年1月至2020年12月收治的85例创伤性CAP患者作为病例组,同期住院的167例非创伤性CAP患者作为对照组。采用多因素二元Logistic回归分析探讨影响因素。

结果

252例患者中应激性损伤发生率为33.73%。这些患者中受影响最严重的部位是骶尾部(24.26%)。大多数患者处于一期(49.50%)。RICU中CAP患者应激性损伤的相关因素为CURB-65评分联合脑血管疾病、发热联合心脏病,且白蛋白是独立危险因素。

结论

应鼓励通过制定可衡量的护理标准流程来改善CAP患者的应激性损伤。包括应经常更换患者的衣物和被褥、管理营养以及保持患者皮肤清洁干燥等措施。使用防护工具以及家庭成员及时参与患者管理可进一步减少应激的发生。

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