摘要
目的 探讨基于皮肤微环境干预的护理措施对结直肠癌手术患者术中获得性压力性损伤(IAPI)的影响。方法 将72例结直肠癌手术患者按随机数字表法分为对照组和研究组,每组36例。对照组患者手术期间采用常规护理,研究组患者采用基于皮肤微环境干预的护理措施。采用外接型高精度电子温度计,皮肤检测仪分别监测患者术中1.5 h、手术结束时受压部位肩部、骶尾部、足跟部的皮肤温度及湿度;采用美国国家皮肤压力性损伤咨询委员会(NPUAP)2016年提出的新版压力性损伤分期系统及定义,评估患者术后3 d内IAPI发生情况;采用Munro量表评估患者围术期发生IAPI的风险;采用舒适状况量表(GCQ)评估患者术后48 h的舒适度。结果 研究组患者术中1.5 h、手术结束时,肩部、骶尾部、足跟部受压部位皮肤温度、湿度均低于对照组患者,差异均有统计学意义(P<0.05)。2组患者Munro量表术前评分比较,差异无统计学意义(P>0.05)。研究组患者Munro量表术前术中评分、围术期评分均低于对照组患者,差异均有统计学意义(P<0.05)。干预期间研究组IAPI发生率低于对照组患者,差异无统计学意义(P>0.05)。术后48 h,研究组患者GCQ量表评分中生理状况、心理精神维度以及总分均高于对照组患者,差异均有统计学意义(P<0.05)。结论 基于皮肤微环境干预的护理措施可以减少结直肠癌患者术中受压部位皮肤微环境的改变,降低患者发生IAPI的风险,提高患者舒适度体验.
Objective To investigate the effect of skin microenvironment-based nursing on the intraoperative acquired pressure injury(IAPI)of colorectal cancer(CRC)patients.Methods A total of 72 surgically treated CRC patients were randomly allocated to control group(n=36)and experimental group(n=36),Conventional nursing,and skin microenvironment—based nursing were respectively applied to control group and experimental group.The external high-precision electronic thermometer and the skin detector were performed to monitor the skin temperature and humidity of the compressed shoulder,sacrococcygeal joint and heel at the 1.5th hour intraoperatively,and at the end of the operation.IAPI within 3 days after surgery was evaluated according to the new version of pressure injury definition and staging system proposed by the National Skin Pressure Injury Advisory Committee(NPUAP)in 2016.The risk of IAPI in CRC patients during perioperative period was evaluated using the Munro Scale.The comfort level at 48 hours after surgery was evaluated using the General Comfort Questionnaire(GCQ).Results The skin temperature and humidity of the compressed shoulder,sacrococcygeal joint and heel at the 1.5th hour intraoperatively,and the end of the operation in the experimental group were significantly lower than those in the control group(P<0.05).There were no significant differences in preoperative Munro scale scores between groups(P>0.05).The pre-,intra-and postoperative Munro scale scores in the experimental group were significantly lower than those in the control group(P<0.05).IAPI was not reported in the experimental group(P>0.05).At 48 h postoperatively,the physical condition,mental and spiritual dimensions and the total scores in the GCQ Scale were significantly higher in the experimental group than those in the control group(P<0.05).Conclusion Skin microenvironment-based nursing can reduce the microenvironment changes of the skin under pressure,reduce the IAPI risk and improve the level of comfort in CRC patients.
作者
胡敏
王娟
张代英
梁瑞晨
刘青焱
HU Min;WANG Juan;ZHANG Daiying(Operating Room,THE Affiliated Hospital of Southwest Medical University,Sichuan,Luzhou 646000,China)
出处
《河北医药》
CAS
2023年第6期865-868,共4页
Hebei Medical Journal
基金
四川省基层卫生事业发展研究中心科研项目(编号:SWFZ19-Y-37)。
关键词
皮肤
温度
湿度
术中获得性压力损伤
skin
temperature
humidity
intraoperative acquired pressure injury
