ICU住院患者压疮发生危险因素的病例对照研究

Risk factors of pressure ulcers in ICU patients:a case-control study

目的探索ICU患者压疮发生相关危险因素,为采取针对性预防措施提供依据。方法参考相关文献拟定ICU患者压疮危险因素调查表,经专家审定后用于某三级甲等医院ICU住院患者资料的收集。365例患者纳入研究,将发生院内获得性压疮的164例归为病例组,符合纳入标准患者中方便抽取未发生压疮的201例归为对照组,以性别、年龄、手术、体温、Norton评分等19项变量进行探索性非配比病例对照研究。结果单因素分析除营养状态、体位、吸烟及白细胞数4项变量两组比较差异无统计学意义(均P>0.05)外,其余15项差异有统计学意义(P<0.05,P<0.01);多因素Logistic回归分析显示年龄、住院时间、Norton评分、体温、APTT、白蛋白数、血红蛋白数是压疮影响因素(P<0.05,P<0.01)。结论ICU住院患者压疮发生受多种因素的影响,应针对上述危险因素采取有据可依的预防措施,以降低压疮发生率。

Objective To explore risk factors of pressure ulcers in ICU patients,and to provide information for taking evidence-based preventive measures. Methods A self-designed questionnaire was developed by using literature review and experts consultation in terms of risk factors of pressure ulcers in ICU patients.A non-matched case-control study was conducted among 365 ICU patients in a top-notch hospital,164 of them with pressure ulcers were treated as cases and 201 without pressure ulcers as controls.Nineteen variables such as gender,age,operation types,body temperature,Norton scores etc,were studied. Results Except nutritional status,body posture,smoking and values of leukocytes,the other 15 variables in the two groups were significantly different（P〈0.05,P〈0.01）.Multivariate Logistic regression analysis showed age,length of hospital stay,Norton scores,body temperature,APTT,albumin value,and hemoglobin value were risk factors of pressure ulcers in ICU patients（P〈0.05,P〈0.01）. Conclusion Multiple risk factors can affect occurrence of pressure ulcers in ICU patients.We should take evidence-based preventive measures to reduce pressure ulcers.