基于微环境理论的延续性护理对截瘫患者皮瓣修复术后再发压力性损伤的影响

Effect of Continuity of Care Based on Microclimate Theory on the Recurrence of Pressure Injury in Patients with Paraplegia After Skin Flap Repair Operation

目的 探讨基于微环境理论的延续性护理对截瘫患者皮瓣修复术后再发压力性损伤(pressure injury,PI)的影响,以期为提高延续性护理质量提供依据。方法 2016年1月至2020年3月,便利抽样法选取截瘫伴PI患者132例为研究对象,按随机数字表法将其分为观察组和对照组,对照组给予常规术后护理和随访,观察组在对照组的基础上给予基于微环境理论的延续性护理,主要包括居室和皮肤局部的温湿度调控。两组患者均进行前瞻性随访记录PI首次再发情况,随访间隙3个月。结果 对照组有9例再发PI,无PI生存时间M(P_(0)~P_(100))为7(1~29)个月;观察组有3例再发PI,无PI生存时间M(P_(0)~P_(100))为32(13~36)个月。两组无PI复发生存曲线差异有统计学意义(χ^(2)=3.958,P=0.047)。结论 在微环境理论指导下的延续性护理能减少深度PI截瘫患者皮瓣修复术后PI的再发,值得推广。

Objective To explore the effect of continuity of care based on microclimate theory on the recurrence of pressure injury(PI)in patients with paraplegia after skin flap repair operation,and to provide basis for the improvement of nursing quality.Methods From January 2016 to March 2020,132 patients with paraplegia PI were selected as the research objects by the convenience sampling method,and were divided into the observation group and the control group according to random number table method.The control group was given routine nursing and postoperative follow-up,while the observation group were given additional continuity of care based on the theory of the microclimate mainly including the bedroom and local skin temperature and humidity control.Patients in both groups were prospectively followed up to record the first recurrence of PI every 3 months.Results 9 cases in the control group showed recurrence of PI with the PI-free survival time of 7(1-29)months;3 cases in the observation group showed recurrence of PI with the PI-free survival time of 32(13-36)months.There was a statistically significant difference in PI-free survival curves between the 2 groups(χ^(2)=3.958,P=0.047).Conclusions Continuity of care based on microclimate theory can reduce PI recurrence after skin flap repair operation in paraplegia patients with deep PI,which was worthy of further promotion.