外科住院患者发生压疮的危险因素分析

Investigation on incidence and risk factors of pressure ulcer in surgical patients

目的：分析外科患者的压疮发生的相关危险因素。方法对10737例住院患者应用 Braden量表进行压疮风险评估，对于有压疮发生危险患者（Braden 评分≤18分）进行动态观察，了解患者压疮发生情况；同时收集院外带入压疮患者的临床资料，分析压疮发生的危险因素。结果10737例患者压疮发生率为0．54％，其中神经外科压疮发生率最高（1．46％），其次是骨科（0．61％），明显高于其他科室，差异有统计学意义（P ＜0．05）。单因素分析显示年龄、吸烟、营养、糖尿病、瘫痪、大、小便失禁、意识、手术情况、血清白蛋白、使用止痛剂、有无照料者等与压疮的发生密切相关，差异有统计学意义（P ＜0．05）；多因素 Logistic 回归分析显示年龄、糖尿病、瘫痪、意识、白蛋白水平、使用止痛剂、有无照料者是患者发生压疮的独立危险因素。结论影响压疮发生的因素较多，而年龄、糖尿病、瘫痪、意识、白蛋白水平、使用止痛剂、有无照料者是发生压疮的独立危险因素。

Objective To discuss the incidence and risk factors of pressure ulcer in surgical patients of our hospital.Methods Totally 10 737 surgical patients were recruited.The patients were assessed by the Braden Scale. The incidence of pressure ulcer in patients with the Braden score lower than 18 was recorded.Besides,the data of patients with pressure ulcers on admission were also collected.All risk factors in patients with pressure ulcer were ana-lyzed.Results The incidence rate of pressure ulcer in surgical patients was 0.54%.The incidence of pressure ulcer was highest in department of Neurosurgery（1.46%）,followed by the department of Orthopedics（0.61%）,which was significantly higher than other departments,the difference was statistically significant（P ＆lt;0.05）.Single factor analy-sis indicated that age,smoking,nutrition,diabetes,paralysis,and large,urinary incontinence,consciousness,operation situation,serum albumin,use of analgesics,presence of caregivers contributed to pressure ulcer,the difference was sta-tistically significant（P ＆lt;0.05）.Multivariable logistic regression analysis showed that age,diabetes,paralysis,con-sciousness,albumin levels,use of analgesic,presence of caregivers were independent risk factors of pressure ulcers in patients.Conclusion There are many factors affecting the incidence of pressure ulcer,while age,diabetes,paralysis, consciousness,albumin levels,use of analgesic,presence of caregivers are independent risk factors of pressure ulcers.