剖宫产术后发生压疮的高危因素分析及预防

ANALYSIS OF HIGH RISK FACTORS AND PREVENTIVE OF PRESSURE ULCER AFTER CAESAREAN SECTION

目的探讨引起剖宫产术后压疮的高危因素及预防性护理。方法采用回顾性调查法,调查可能与术后压疮相关的术中及术后高危因素,包括:体质量指数,血红蛋白水平、病房条件、季节、胎膜早破、术后使用镇痛泵、手术时间、年龄8项指标。将40例剖宫产术后压疮患者作为观察组,选择同期无术后压疮剖宫产患者50例作为对照组,对可能影响术后压疮的高危因素进行单因素分析与Logistic回归分析。结果影响术后压疮的高危因素单因素分析发现产妇体质量指数高、血红蛋白水平低、病房条件、夏季、胎膜早破、手术时间长、术后使用镇痛泵与剖宫产术后压疮有关;Logistic回归分析确定手术时间长、季节、胎膜早破、体质量指数高、术后使用镇痛泵为术后压疮的相关危险因素。结论应针对高危因素采取护理措施:缩短手术时间,完善夏季卫生管理,加强胎膜早破的护理,进行营养健康教育,适当活动预防术后压疮,建议镇痛泵选择性用于痛阈较低的产妇。

Objective To explore the high risk factors leading to the pressure ulcer after caesarean section and the preventive nursing. Methods Retrospective analysis was used to detect the intraoperative and postoperative high risk factors possibly rela- tive to the pressure ulcer, including BMI, hemoglobin, ward conditions, season, premature rupture of membrane, postoperative anesthesia pump, operation time and age. 40 cases with postoperative pressure ulcer were collected into observation group while another 50 cases without pressure ulcer in blank group. The probable high risk factors were analyzed with single factor analysis and Logistic re- gression analysis. Results Single factor analysis showed the high rick factors such as high BMI, low hemoglobin level, crowed ward conditions, sununer, premature rupture of membrane, prolonged time of operation and the usage of anesthesia pump played roles in postoperative pressure ulcer; Logistic regression analysis showed the high risk factors related to the postoperative pressure ulcer were prolonged time of operation, season, premature rupture of membrane, high BMI and the usage of anesthesia pump. Conclusion The nursing intervention should focus more attention on the high risk factors , such as shortening time for operation, better health supervi- sion in summer,more nursing care in premature rupture of membrane, education for noruishment,adequate activity and providing the postoperative anesthesia pump to the parturient with relative low threshold for pain.