影响压疮愈合的危险因素分析

Analysis of risk factors of pressure ulcer healing

目的 探讨影响压疮患者治疗30 d后创面愈合的危险因素.方法 选取2015年1月至2016年10月住院的压疮患者245例,治疗30 d时根据是否愈合分组,压疮愈合的84例为愈合组,压疮未愈合的161例为未愈合组.观察患者年龄、性别、卧床、水肿、多病并存、压疮个数、压疮面积、压疮愈合评价量表（PUSH）、Hb、血清白蛋白（Alb）、LDL-C及血同型半胱氨酸（Hcy）12项指标,进行单因素及多因素回归分析.结果 对12项指标进行单因素分析,影响压疮愈合的危险因素有年龄、Hb、Alb、Hcy、压疮面积、PUSH评分6项指标进入回归方程（Z=3.11~6.63,均P〈0.01）,性别也进入回归方程（χ2=0.19,P〈0.01）;进一步经多因素回归分析发现PUSH评分指标的差异有统计学意义（χ2=10.47,P〈0.01,OR=0.001,95%可信区间为0.001~0.037）.结论 对于压疮治疗30 d后创面愈合而言,影响压疮愈合的危险因素有年龄、性别、Hb、Alb、Hcy、压疮面积等指标.

Objective To investigate the risk factors of wound healing 30 days after treatment in patients with pressure ulcer. Methods Two hundred and forty-five hospitalized patients with pressure ulcer between January 2015 and October 2016 were selected. They were divided into the healed group and the unhealed group 30 days after the treatment. The influencing factors 13 indexes including age, gender, edema, the number of diseases, the number of pressure ulcer, the size of pressure ulcer, PUSH score （Pressure Ulcer Scale Healing）, hemoglobin, serum albumin, low density lipoprotein cholesterol and blood homocysteine underwent single factor and Logistic regression analysis. Results Single factor analysis of 12 indicators of risk factors affecting healing were age, Hb, Alb, Hcy, area of ulcer and PUSH scores of the 6 indicators in the regression equation （Z=3.11-6.63, All P 〈 0.01）, gender also entered the regression equation （χ2=0.19, P〈0.01）;further multivariate regression analysis showed that there were statistically significant differences in PUSH score index （χ2=10.47, P〈0.01, OR=0.001, 95%confidence interval were 0.001-0.037）. Conclusions Age, gender, Hb, Alb, Hcy and PU area were the risk factors of pressure ulcer healing.