ICU无创正压通气患者发生鼻面部压力性损伤危险因素分析

Risk factors of facial and nasal bridge pressure injuries in ICU patients requiring noninvasive positive-pressure ventilation

目的探讨重症监护室(ICU)无创正压通气(NPPV)患者发生鼻面部压力性损伤的危险因素,为制定预防鼻面部压力性损伤措施提供参考。方法选取2015年1月—2017年12月ICU收治的行NPPV患者189例为研究对象,对其中10例发生压力性损伤患者(压力性损伤组)与179例未发生压力性损伤患者(未发生压力性损伤组)的病历资料进行回顾性分析,使用Cox回归模型分析ICU行NPPV患者发生鼻面部压力性损伤独立危险因素。结果经调查发现,189例NPPV患者发生鼻面部压力性损伤10(5.29%)例,其中1期8(4.23%)例,2期2(1.06%)例。Cox回归模型分析发现高龄、上机形式、面部皮肤潮湿高热、强迫体位及患者合并有糖尿病等慢性疾病是NPPV发生患者鼻面部压力性损伤的独立危险因素(P<0.01)。结论高龄、上机形式、面部皮肤潮湿高热、强迫体位及患者合并糖尿病等慢性疾病是ICU的NPPV患者鼻面部压力性损伤的独立危险因素。护理人员应高度重视,采取积极应对保护措施,预防和降低NPPV患者鼻面部压力性损伤发生风险,保障患者的护理安全。

Objective To investigate the risk factors of facial and nasal bridge pressure injuries in ICU patients requiring noninvasive positive-pressure ventilation(NPPV),and provide reference for the prevention of facial and nasal bridge pressure injuries.Methods The clinical data of 189 ICU patients requiring NPPV were retrospectively analyzed.Patients were divided into two groups,10 cases with development of pressure injuries(PI group)and 179 without development of PI(non-PI group).The Cox regression model was adopted to investigate the independent risk factors of facial and nasal bridge pressure injuries.Results The incidence of facial and nasal bridge pressure injuries was 5.29%(10/189),with 8(4.23%)cases of stage 1 pressure injuries and 2(1.06%)cases of stage 2 pressure injuries.The Cox regression analysis showed that advanced age,ventilation mode,damp-heat skin,forced posture,complicating chronic diseases such as diabetes mellitus were independent risk factors of facial and nasal bridge pressure injuries(P<0.01).Conclusion The advanced age,ventilation mode,damp-heat skin,forced posture,complicating chronic diseases are independent risk factors of facial and nasal bridge pressure injuries among ICU patients requiring NPPV.Preventive measures should be carried out to reduce the risk of facial and nasal bridge pressure injuries and ensure the safety of patients.