摘要
目的调查ICU呼吸衰竭患者院内获得性压力性损伤的发生情况,探讨发生的影响因素。方法采用回顾性调查方法,运用自行设计的调查表进行调查,共纳入187例患者进行研究。结果187例患者在ICU住院期间,共15人发生压力性损伤,呼吸衰竭患者院内获得性压力性损伤的发生率为8.02%;经分析院内获得性压力性损伤发生的独立危险因素包括APACHEⅡ评分(OR=1.414,95%CI:1.092~1.830,P=0.009)、呼吸机使用时间(OR=1.004,95%CI:1.001~1.007,P=0.021)、氧合指数(OR=0.977,95%CI:0.959~0.996,P=0.016)。结论呼吸衰竭患者是发生压力性损伤的高危人群,应加强预防措施;应通过Waterlow压力性损伤风险评分、APACHEⅡ评分等工具对压力性损伤预防进行指导;在压力性损伤预防中应注重患者基础病情的改善,在工作中做到预防为主,及时干预,积极预防呼吸衰竭患者院内压力性损伤的发生。
Objective This study aims to describe the incidence and risk factors of hospital-acquired pressure injury in patients who are admitted in intensive care unit(ICU)with respiratory failure.Methods A total of 187 patients were involved in this retrospective study.A self-designed scale was used for evaluating pressure injury.Results During the ICU hospitalization,fifteen of 187 patients suffered from stress injury.The incidence of hospital-acquired pressure injury was 8.02%.APACHE II scores(OR=1.414,95%CI:1.092-1.830,P=0.009),duration of mechanical ventilation(OR=1.004,95%CI:1.001-1.007,P=0.021),and oxygenation index(OR=0.977,95%CI:0.959-0.996,P=0.016).Conclusion Patients with respiratory failure are high-risk group with stress injuries,and preventive measures should be strengthened.Waterlow pressure sore risk scale and APACHE II score guide to the prevention of stress injury.Improvement of patients’basic disease,timely intervention and actively prevention can aid in the occurrence of hospital-acquired pressure injury of respiratory failure.
作者
孙仲文
李佳芮
蒋梦笑
SUN Zhongwen;LI Jiarui;JIANG Mengxiao(Cancer Center of Sun Yat-sen University,Guangzhou 510060,China)