住院患者皮肤撕裂伤的危险因素分析

Analysis of Risk Factors for Skin Tears among Chinese Inpatients

目的探讨住院患者皮肤撕裂伤的危险因素,以期为住院患者预防皮肤撕裂伤提供依据。方法 2015年4月实施调研,前期采用网上招募、各医院自愿报名、课题组审査的方式,确定来自9个省11个城市的14所三级甲等综合医院参与本研究。共纳入18 806例住院患者,使用研究者自行设计的住院患者一般资料表、皮肤观察资料表对其进行调查。结果单因素分析表明,年龄、性别、营养途径、白蛋白值、血红蛋白值、Braden评分、感知能力、潮湿度、活动能力、移动能力、营养摄入、摩擦力和剪切力、皮肤撕裂伤发生史及辅助工具使用等14项因素对是否发生皮肤撕裂差异均有统计学意义(均P<0.05)。对上述因素进行Logistic回归分析,结果表明年龄、性别、营养途径、白蛋白、血红蛋白、活动能力、营养摄入、ST发生史和辅助工具的使用等9项因素对皮肤撕裂伤的发生有影响(均P<0.05)。结论年龄、性别、营养途径、白蛋白、血红蛋白、活动能力、营养摄入、ST发生史和辅助工具的使用是住院患者发生皮肤撕裂伤的独立危险因素,应加强观察,根据危险因素制定相应的预防措施以降低皮肤撕裂伤的发生率。

Objective To investigate and analyze the risk factors related to skin tears among Chinese inpatients,in order to provide evidence for inpatients＇ prevention of skin tears.Methods Through online recruitment,voluntary registration and research group review,totally 18806 inpatientsfrom 14 ClassⅢGradeⅠhospitals in 11 cities of 9 provinceswere included and suveryed by self-designed general questionnaire and skin observation scale.Results Univariate analysis showed that age,gender,nutrition pathway,albumin value,hemoglobin value,Braden score,perception,humidity,mobility,locomotivity,nutrient intake,friction and shear,history of skin tears and the use of assistive tools were statistically significant for the occurrence of skin tears（all P〈0.05）.Logistic regression analysis of the above factors showed that age,gender,nutrition pathway,albumin,hemoglobin,mobility,nutrion intake,history of skin tears,and use of assistive tools significantly influenced the occurrence of skin tears（all P〈0.05）.Conclusions Age,gender,nutritionpathway,albumin,hemoglobin,mobility,nutrition intake,history of skin tears,and use of assistive tools are independent risk factors for skin tears.Clinical observation should be intensified and appropriate preventive measures should be taken to reduce the incidence of skin tears.