开颅手术患者术中急性压疮的危险因素分析

Analysis on the risk factors of intraoperative acute pressure ulcers in patients received craniotomy

目的探讨开颅手术过程中急性压疮发生的危险因素,为临床护理人员筛选压疮高危人群、制定术中急性压疮的防控措施提供参考。方法回顾性分析2015年7月至2016年6月住院并接受开颅手术的211例患者的病案资料,依据离开手术室时皮肤是否出现压疮分为压疮组和对照组,采用单因素分析和非条件多因素Logistic回归分析术中急性压疮的危险因素。结果 211例开颅手术患者中发生术中急性压疮患者19例,共32处压疮,压疮发生率为9.00%;压疮组和对照组在年龄、体质量指数(BMI)、术前空腹血糖、术前Braden评分、手术时间、美国麻醉协会(ASA)麻醉分级以及手术情况等方面差异有统计学意义(P<0.05);非条件多因素Logistic回归分析结果提示,术前Braden评分、术前空腹血糖以及手术时间是开颅手术患者术中急性压疮的危险因素(P<0.05)。结论针对筛选出的压疮高危人群,应采取综合干预措施,降低开颅手术患者术中急性压疮发生率,提高医疗质量。

Objective To explore the risk factors of intraoperative acute pressure ulcers in patients received craniotomy,aiming to screen the high-risk group of pressure ulcers and offer a reference for effective precaution for the clinical nureses. Methods The clinical data of 211 patients received craniotomy at department of neuro-surgery of certain tertiary hospital in Anhui province from July 2015 to June 2016 were collected retrospectively. The patients were divided into pressure ulcer group and control group based on the occurrence of pressure ulcers after craniotomy. The univariate and non-conditional logistic regression analysis were applied to discuss the influence factors of intraoperative acute pressure ulcer. Results There were 19 cases and a total of 32 pressure ulcers in 211 patients received craniotomy,with a 9 % incidence of pressure ulcers. The age,BMI,preoperative fasting blood sugar level and Braden score,length of operation,ASA grading and surgery condition were significantly different between the pressure ulcer group and control group（P〈0. 05）,the multivariate logistic regression analysis showed that length of operation,preoperative fasting blood-sugar level and Braden score were the risk factors（P〈0. 05）. Conclusion The comprehensive measures should be taken to reduce the incidence of intraoperative acute pressure ulcers and improve the medical quality for high-risk people of pressure ulcers.