老年住院患者压疮的风险评估及防治策略

Prediction and prevention and treatment of pressure ulcers in hospitalized elderly patients.

目的压疮是老年患者院内问题之一，在高龄化患者激增的形势下，需要引起各专科的重视。方法对北京协和医院老年示范病房过去4年内收治的780例老年患者进行回顾性资料分析，采用Braden压疮风险评估量表，预测压疮发生的风险，从而采取积极有效地预防措施。结果成功地预防了所有住院老年患者的压疮发生。对人院时已发生Ⅱ度及Ⅱ度以上压疮的8例患者，根据压疮发展的分期，采用调整功能状态及系统疾病等个性化的治疗方案，从而促进压疮的愈合。结论湿性伤口愈合方法，正确选择合适的伤口敷料是成功治疗压疮的关键，但是以责任护士为主的老年医学团队的配合，去除风险因素，预防压疮为先则更为重要。需要做进一步的临床观察来评估上述综合措施的成效。

Objective To evaluate the risk of pressure ulcers （PU） in older Chinese patients as well the effectiveness of preventive and therapeutic measures for pressure ulcers. Methods Totally 780 elderly patients admitted to the Geriatrics Demonstration Word at Peking Union Medical College Hospital during last four years were retrospectively analyzed. Braden scale was administered to predict the risk of pressure ulcers. Results Pressure ulcers had been prevented effectively in all patients with no new cases occurred. 8 patients had pressure ulcers at stage II and above on the admission. With implementation of preventive and treatment measures, including functional rehabilitation, individualized chronic disease management, moist wound healing method, proper wound dressings, these pressure ulcers were healed. Conclusions Risk assessment with Braden scale, individualized prevention and treatment appear to be effective for pressure ulcer management. Further studies are needed for evaluation of these measures, in the elderly.