对侧支撑技术对患者翻身后体位移位问题的研究

The effect of contralateral support technology on postural displacement of long-term bedridden patients after turning over

目的探讨对侧支撑技术对长期卧床且床上无法自主活动的患者，在临床中翻身后对侧体位移位问题的作用。方法将100例符合条件的患者按人科先后顺序分成对照组与试验组各50例，对照组使用传统三角形翻身垫翻身，试验组使用组合式翻身垫翻身，每2小时翻身1次，观察患者的皮肤情况，是否出现体位移位和移位用时，连续观察24h并记录6次。结果试验组患者的体位移位发生率、异常皮肤发生率及体位移位用时分别为28．67％（86／300）、5．00％（15／300）、（99．0±18．5）min，对照组分别为65．33％（196／300）、9．00％（27／300）、（78．2±31．6）min，2组比较差异有统计学意义（χ2=80．958、3．687，t=4．014，均P〈0．01）。结论随着患者肌力的增加，患者翻身后出现体位移位的比率逐渐提高，发生体位移位所用的时间逐渐缩短，增加了剪切力对皮肤的损伤和无效体位所导致的皮肤因反复受压而发生压力性损伤的风险；而对侧支撑技术在很大程度上减少了体位移位的发生，从而能够降低发生压力性损伤的风险。

Objective To study the effect of contra lateral support technology on the contra lateral postural displacement of long-term bed ridden patients and patients of inability to perform voluntary movements in clinical practice. Methods 100 eligible patients were divided into control group and experimental group according to the admission sequence. 50 patients in the control group use traditional triangle mat to turn over for every 2 hours, and 50 patients in the experimental group use combined mat to turn over at the same frequency. Postural displacement on the patient＇s skin and the displacement time were observed for 24 hours and recorded for 6 times. Results The incidence rate of postural displacement, abnormal skin and the mean time of displacement of the control group were 28.67% （86/ 300）, 5.00%（15/300）, （99.0 ± 18.5） min, and that of the experimental group were 65.33%（196/300）, 9.00% （27/300）, （78.2 ± 31.6） min. The differences between both groups were statistically significant （χ2=80.958, 3.687, t=4.014, all P〈0.05）. Conclusions With the patient＇s muscle strength increasing, the ratio of postural displacement after turning over gradually increases, and the mean time for displacement gradually decreases, increasing the damage on the skin by shear force and the risk of stress injury due to invalid position. However, the contra lateral support technology could reduce the occurrence of postural displacement to a large extent, thus decreasing risk of stress injury.