应用集束化护理预防成人体外循环心脏手术患者围手术期急性压疮的实践

The application of cluster nursing on acute pressure ulcers prevention among cardiac surgery patients with extracorporeal circulation

目的 :评价集束化护理在成人体外循环心脏手术患者围手术期急性压疮预防中的作用。方法 :将2014年2月1日至8月31日经体外循环心脏手术后入住ICU的压疮高危患者作为对照组(62例)进行历史回顾,将2014年12月1日至2015年6月30日术后入住ICU的压疮高危患者作为观察组(111例)。采用集束化护理对观察组进行干预。结果 :对照组中15例发生I期压疮,2例发生Ⅱ期压疮,1例发生Ⅲ期压疮,压疮发生率为29.03%;观察组中6例发生I期压疮,无Ⅱ期和Ⅲ期压疮发生,压疮发生率为5.41%;两组压疮发生率比较差异有统计学意义(P<0.01)。结论 :针对成人体外循环心脏手术压疮高危患者实施集束化压疮预防管理措施,可以有效降低其围手术期压疮的发生率。

Objective： To evaluate the effects of cluster nursing on acute pressure ulcers prevention among cardiac surgery patients with extracorporeal circulation. Methods： High pressure ulcer risk patients with Braden score12 within 24h in ICU from Feb. to Aug. 2014 were recruited and reviewed as control group（62 cases）, while the similar patients in ICU from Dec. 2014 to June 2015 were recruited as observation group （111 cases）. The observation group received cluster nursing intervention. Results： In the control group, 15 patients, 2 patients and 1 patient developed level I , level II level III pressure ulcers , respectively, The pressure ulcer rate in the control group was 29.03%. In the observation group, only 6 patients developed level I pressure ulcers. The pressure ulcer rate in observation group was 5.41%. The differences of pressure ulcer rate between the two groups was statistically significant （P〈0.01）. Conclusion： Cluster nursing could decrease the incidence of pressure ulcers among high risk cardiac surgery patients with cardiopulmonary bypass.