脑卒中患者压力性损伤风险危险因素分析

Analysis on the risk factors of stress injury in patients with stroke

目的探讨脑卒中患者压力性损伤风险现状及影响因素,并制订相关管理措施,旨在为预防脑卒中患者发生压力性损伤提供依据。方法回顾性分析2018年6月至2019年6月本院收治的脑卒中患者106例临床完整资料,将未发生压力性损伤患者79例设为对照组,将已发生压力性损伤患者27例设为观察组。设计一般情况调查表,仔细查阅患者病历资料,详细记录两组患者一般资料,包括性别、年龄、体质量指数(BMI)、脑卒中类型(脑出血及脑梗死)、糖尿病、是否感染(尿路感染、肺部感染、胃肠道感染)、营养状况、潮湿环境、摩擦力、剪切力、感觉功能障碍、压疮危险评分(Waterlow)等。经单因素、多因素分析脑卒中患者治疗期间发生压力性损伤的风险因素。结果两组患者年龄≥70岁、营养不良、感觉功能障碍、压疮危险评分>20分、潮湿环境、摩擦力、剪切力比较,差异有统计学意义(P<0.05)。经非条件多项Logistic回归分析显示,年龄≥70岁、营养不良、感觉功能障碍、压疮危险评分>20分、潮湿环境、摩擦力、剪切力可能是导致脑卒中患者发生压力性损伤的危险因素(OR>1,P<0.05)。结论年龄≥70岁、营养不良、感觉功能障碍、压疮危险评分>20分、潮湿环境、摩擦力及剪切力均可能增加脑卒中患者发生压力性损伤的风险,故临床需针对相关风险因素,积极制订早期预防护理管理措施,以预防发生压力性损伤。

Objective To explore the current status and influencing factors of pressure injury in stroke patients,and to formulate relevant management measures,in a bid to provide evidence for the prevention of pressure injury in stroke patients.Methods The clinical complete data of 106 stroke patients who were admitted to our hospital from June 2018 to June 2019 were retrospectively analyzed.79 patients without pressure injury were included in the control group,and 27 patients with pressure injury were included in the observation group.A general survey form was designed,and the patient′s medical records were carefully reviewed.The general information of both groups of patients,including gender,age,body mass index(BMI),types of stroke(cerebral hemorrhage and cerebral infarction),diabetes,infection(urinary tract infection,lung infection,gastrointestinal infection),nutritional conditions,humid environment,friction force,shear force,sensory dysfunction,and pressure ulcer risk score(Waterlow)were recorded in detail.The risk factors of stress injury during the treatment for stroke patients were analyzed by univariate and multivariate factors.Results There were statistically significant differences between the two groups in age≥70 years old,malnutrition,sensory dysfunction,pressure ulcer risk score>20 points,humid environment,friction force,and shear force(P<0.05).Unconditional multiple logistic regression analysis confirmed that age≥70 years old,malnutrition,sensory dysfunction,pressure ulcer risk score>20 points,humid environment,friction force,and shear force may be risk factors for pressure injury in stroke patients(OR>1,P<0.05).Conclusion Age≥70 years old,malnutrition,sensory dysfunction,pressure ulcer risk score>20 points,humid environment,friction force or shear force may all increase the risk of pressure injury in stroke patients.Therefore,it is necessary to actively develop early preventive care management measures in accordance with relevant risk factors in clinical practice,so as to prevent stress injuries.