集束化护理对骨科患者压疮的预防作用及血清IL-6和TNF-α对压疮发生的预测价值
Preventive effect of cluster nursing on pressure ulcers in orthopedic patients and predictive value of serum IL-6 and TNF-α for the occurrence of pressure ulcers.
作者信息
Zhu Yan, Luo Minghua, Liu Qiongshan, Liu Hankun
机构信息
Orthopedics and Traumatology, The Seventh Affiliated Hospital of Sun Yat-sen University Shenzhen 518107, Guangdong, China.
Cardiovascular Center, The Seventh Affiliated Hospital of Sun Yat-sen University Shenzhen 518107, Guangdong, China.
出版信息
Am J Transl Res. 2023 Feb 15;15(2):1140-1149. eCollection 2023.
OBJECTIVE
To determine the effect of cluster nursing on pressure ulcer prevention and comfort of orthopedic patients.
METHODS
A total of 124 orthopedic inpatients admitted to the Seventh Affiliated Hospital of Sun Yat-sen University from July 2018 to June 2021 were retrospectively analyzed. Among them, 66 cases received cluster nursing who were assigned into the observation group and the other 58 cases received routine nursing and were assigned into the control group. The incidence of pressure ulcers, the degree of pressure the ulcer, quality of life-brief (QOL-BREF), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores of the two groups at 7 days after surgery were compared, and the comfort score and nursing satisfaction of the two groups were evaluated and compared. The expression and predictive value of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with pressure ulcers before operation were analyzed via enzyme-linked immunosorbent assay (ELISA). The levels of IL-6 and TNF-α were compared between the two groups before and after nursing.
RESULTS
After nursing, the observation group had significantly lower IL-6, TNF-α, SAS score, and SDS scores than the control group, and showed significantly higher QOL-BREF score, nursing satisfaction and comfort scores than the control group. In addition, the observation group showed a significantly lower incidence of pressure ulcers and a significantly lower severity level than the control group after nursing. Patients with pressure ulcers showed significantly higher serum IL-6 and TNF-α levels before surgery, and receiver operating characteristic curve (ROC) showed that IL-6 and TNF-α had certain value in forecasting the occurrence of pressure ulcers.
CONCLUSION
Cluster nursing can substantially lower the incidence of pressure ulcers in hospitalized orthopedic patients and improve their comfort.
目的
探讨集束化护理对骨科患者压疮预防及舒适度的影响。
方法
回顾性分析2018年7月至2021年6月中山大学附属第七医院收治的124例骨科住院患者。其中，66例接受集束化护理，为观察组；另外58例接受常规护理，为对照组。比较两组患者术后7天的压疮发生率、压疮程度、生活质量简表（QOL-BREF）、焦虑自评量表（SAS）及抑郁自评量表（SDS）评分，并对两组患者的舒适度评分及护理满意度进行评估和比较。采用酶联免疫吸附测定（ELISA）法分析术前压疮患者血清白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的表达及预测价值。比较两组护理前后IL-6和TNF-α水平。
结果
护理后，观察组IL-6、TNF-α、SAS评分及SDS评分均显著低于对照组，QOL-BREF评分、护理满意度及舒适度评分均显著高于对照组。此外，护理后观察组压疮发生率及严重程度均显著低于对照组。术前压疮患者血清IL-6和TNF-α水平显著升高，受试者工作特征曲线（ROC）显示IL-6和TNF-α对预测压疮的发生具有一定价值。
结论
集束化护理可显著降低骨科住院患者压疮发生率，提高其舒适度。
Zotero 插件