预见性压力性损伤防范干预措施在神经外科手术中的应用效果

Application effect of preventive and intervention measures of predictive pressure injury in operation in department of neurosurgery

目的:探讨预见性压力性损伤防范干预措施在神经外科手术中的应用效果。方法:选取2015年1月至2016年3月收治的202例术中高危压力性损伤的患者为对照组,2016年4月至2017年7月收治的203例术中高危压力性损伤的患者为试验组。对照组采用传统压力性损伤护理方法,试验组采用预见性压力性损伤防范干预方法,比较两组患者术后即刻皮肤发生红斑、压力性损伤的例数,两组患者在年龄、手术时间、术中出血量中的差异,统计两组患者红斑、压力性损伤的分布情况。结果:通过预见性干预防范措施后试验组发生红斑、压力性损伤的例数比对照组少,差异有统计学意义(P<0.05);两组患者年龄比较:试验组中≤40岁的颅脑手术患者术中发生红斑、压力性损伤的例数明显小于对照组,有统计学意义(P<0.005);两组患者术中手术持续时间比较:试验组中<3 h、>5 h的手术中患者其发生红斑、压力性损伤的例数小于对照组,有统计学意义(P<0.05);两组术中出血量比较:试验组中出血量在200～800 mL、>800 mL的患者红斑、压力性损伤例数小于对照组有统计学意义(P<0.05);两组患者红斑的平均面积和压力性损伤的例数均有减少,消退时间较前缩短,有统计学意义(P<0.05)。结论:采用预见性压力性损伤防范措施可降低红斑、压力性损伤的发生率,减轻了患者的痛苦,提高手术护理质量。

Objective:To investigate the application effect of predictive stress injury prevention interventions in neurosurgery.Methods:A total of 202 patients with high-risk stress injuries from January 2015 to March 2016 were selected as the control group.203 patients with intraoperative high-risk stress injuries were admitted from April 2016 to July 2017 as the experimental group.The control group used the traditional pressure injury nursing method.The experimental group used the predictive stress injury prevention intervention method.The number of patients with erythema and stress injury immediately after surgery was compared between the two groups,and the differences in age,operation time and intraoperative blood loss between the two groups were compared.The distribution of erythema and stress injury between the two groups was calculated.Results:After the predictive intervention prevention measures,the number of cases of erythema and stress injury in the experimental group was less than that of the control group,and the difference was statistically significant(P<0.05).Age comparison of patients in the two groups:the number of cases of intraoperative erythema and stress injury in craniocerebral surgery patients aged 40 or under 40 years old in the experimental group was significantly lower than that in the control group(P<0.005).Comparison of the duration of intraoperative surgery between the two groups:the number of patients with erythema and stress injury in the experimental group who underwent surgery less than 3 h and more than 5 h was lower than that in the control group,which was statistically significant(P<0.05).Comparison of intraoperative blood loss between the two groups:the number of patients with erythema and stress injury in the experimental group with blood loss of 200~800 ml and more than 800 ml was lower than that in the control group(P<0.05).The mean area of erythema and the number of cases of stress injury were reduced in both groups,and the regression time was shorter than that before operation,with statistical significance(P<0.05).Conclusion:Predictive stress injury prevention measures can reduce the incidence of erythema and stress injury,reduce the pain of patients and improve the quality of surgical care.