改良“三位一体”防护法预防脊柱机器人俯卧位手术中压力性损伤的效果

Effect of modified"Three-in-one"protection method in prevention of pressure injury in patients with prone position surgery by spinal robots

目的探讨改良“三位一体”防护法预防脊柱机器人俯卧位手术中压力性损伤(PI)的效果。方法选择行脊柱机器人椎间融合器植入植骨融合手术患者61例,随机分为观察组31例和对照组30例。观察组采用改良“三位一体”防护法,即联合使用石蜡油、经亲水助剂处理后的熔喷无纺布及硅凝胶垫;对照组采用常规方法,即联合使用液体敷料、泡沫敷料及硅凝胶垫。比较2组患者术后皮肤受压情况(包括皮肤压痕、红斑、水疱、破损等)。结果观察组头面部、左侧髋部、右侧髋部的PI发生率低于对照组,差异均有统计学意义(P<0.05)。观察组黏胶性皮肤损伤发生率为0,低于对照组的16.67%(5/30),差异有统计学意义(P<0.05)。结论脊柱机器人俯卧位手术中应用改良“三位一体”防护法能显著降低PI、黏胶性皮肤损伤发生率。

Objective To investigate the effect of modified"Three-in-one"protection method in prevention of pressure injury(PI)in patients with prone position surgery by spinal robots.Methods A total of 61 patients with interbody fusion cage implantation and bone graft fusion by spinal robots were randomly divided into observation group(n=31)and control group(n=30).The observation group was treated with modified"Three-in-one"protection method,that was the combination of paraffin oil,the melt blown nonwoven fabric and silicone gel pad processed by hydrophilic additives,while the control group was treated with the conventional method,that was the combination of liquid dressing,foam dressing and silicone gel pad.The postoperative condition of pressure on skin(including skin indentation,erythema,blister,damage,etc.)of the two groups were compared.Results The incidence rates of PI in the regions of head and face,left hip and right hip in the observation group were significantly lower than those in the control group(P<0.05).The incidence rate of mucinous skin injury in the observation group was 0,which was significantly lower than 16.67%(5/30)in the control group(P<0.05).Conclusion Application of modified"Three-in-one"protection method in prone position surgery by spinal robots can significantly reduce the incidence rates of PI and mucinous skin injury.