院外压疮临床护理特点的回顾性研究

Retrospective study of the clinical nursing characteristics of pressure ulcer outside hospital

目的分析院外压疮发生的临床特点,以期加深临床护理人员对院外压疮的认识,为预防院外压疮提供参考。方法采用回顾性调查分析的方法,便利抽样选取某三级甲等医院2014年1月—2015年12月272例带有院外压疮的患者,通过调查住院患者病历,压疮会诊单,首次会诊压疮照片,提取患者的一般情况和压疮创面情况资料。数据采用SPSS 19.0统计软件进行分析,利用率、构成比及频数进行数据描述分析。结果 (1)男性占65.4%,女性占34.6%;平均年龄(76.48±9.48)岁,80岁以上的患者占48.2%。(2)90.1%的患者都来自内科,比例较高的科室为呼吸科,神经内科,重症医学科。(3)意识不清楚的占60.7%;96.3%的患者合并慢性病,平均合并2.6种慢性病。(4)5.5%的患者身上无法计算压疮处数,3处及以上的压疮患者占32%,可计算压疮处数的患者共计601处,2.7%发生感染。(5)易发生压疮的部位依次为骶尾、髋部、足跟、臀部、内外踝、背部;压疮分期以Ⅱ期、可疑深部组织损伤期,不可分期为主;面积大小不等,但压疮愈合计分量表(PUSH)面积评分10分的创面占28.8%。结论院外压疮患者一般情况和压疮创面情况有其特点,临床护理人员应结合其临床特点采取有针对性的预防措施。

Objective To analyze the clinical characteristics of pressure ulcers out of hospital,deepen nurses＇ understanding for this kind of pressure ulcers and to provide a reference for prevention of this kind of pressure ulcers.Methods 272 patients diagnosed with pressure ulcers out of hospital who were hospitalized between January 2014 and December 2015 in a third class A hospital selected for the study.Patients＇ general conditions and wound conditions were surveyed through case report,consultation sheet and photos of wound.Adopt SPSS19.0statistical software for data analysis.The percentage,constituent ratio and frequency was used for data description.Results（1）Men accounted for 65.4%,women accounted for34.6%;The average age was（76.48±9.48）,48.2% patients over the age of 80.（2）90.1% of the patients came from medical department and the department of respiratory,neurology,ICU received more patients.（3）Consciousness unclear accounted for 60.7%;96.3% of patients combined chronic diseases.The average of chronic diseases was 2.6.（4）5.5% of patients were unable to calculate pressure ulcers in number and patients with three or more pressure ulcers accounted for 32%.Patients able to calculate the number of pressure ulcers had a total of 601 wounds,2.7% of the wound was infected.（5）The parts of prone to be pressure ulcers orderly was sacral tail,hips,heels,buttocks,internal or external ankle,back;Pressure ulcers stage gave priority to stage Ⅱ,suspicious deep tissue injury and unstageable.The area of the pressure ulcers varied,but wound area scored 10 points in pressure ulcer healing scoring scale（PUHS）occupied 28.8%.Conclusion The general situation and wound conditions in patients with pressure ulcers happened out of hospital had its characteristics.Clinical nursing staff should combine the clinical characteristics and take targeted measures to prevent this kind of pressure ulcers.