神经外科重度昏迷患者压疮发生的危险因素及护理干预对策

Risk factors of pressure ulcer in patients with severe coma in neurosurgery department and its nursing intervention

目的探讨神经外科重度昏迷患者压疮发生的危险因素及护理干预对策。方法选取2015年12月至2017年10月我院神经外科收治的624例重度昏迷患者为研究对象,回顾性分析所有入组患者的诊疗资料,采用COX回归模型(proportional hazarols models,COX)分析影响神经外科重度昏迷患者发生压疮的独立危险因素。结果 624例重度昏迷患者中,106例出现压疮,占总例数的17. 0%;分析发现患者年龄、卧床时长、压疮评分、格拉斯哥(GCS)评分<10分是影响神经外科重度昏迷患者发生压疮的独立危险因素,差异有统计学意义(P <0. 05)。结论神经外科重度昏迷患者相对其他疾病的患者发生压疮的几率更高,主要因素与患者年龄、卧床时长、压疮评分、GCS评分有关;应当根据不同的危险因素制定并实施相对应的护理干预对策,降低患者发生压疮的风险。

Objective To explore the risk factors of pressure ulcer in patients with severe coma in neurosurgery department and its nursing intervention. Methods To select 624 cases of patients with severe coma admitted to the neurosurgery department of our hospital from December 2015 to October 2017 as the study subjects. The diagnosis data of these selected patients were analyzed retrospectively. The independent risk factors affecting the occurrence of pressure ulcers in patients with severe coma in the neurosurgery department were analyzed by COX regression model. Results Among the 624 patients with severe coma, a total of 106 patients had pressure ulcer, accounting for 17.0% of the total number of cases. The analysis showed that age, on-bed time, pressure ulcer score and Glasgow coma scale(GCS)score<10 were independent risk factors for pressure ulcers in patients with severe coma in neurosurgery department,and the difference was statistically significant( P <0.05). Conclusion Patients with severe coma in neurosurgery department have higher incidence of pressure ulcers than patients with other diseases. The main factors are related to the age, on-bed time, pressure ulcer score and GCS score. Therefore, the corresponding nursing intervention strategies should be formulated and implemented according to different risk factors, thus reducing the risk of pressure ulcers.