手术室外科手术患者发生压力性损伤的相关危险因素分析

Analysis of related risk factors of pressure injury in surgical patients in the operating room

目的探讨手术室外科手术患者发生压力性损伤(PI)的相关危险因素。方法以方便抽样方式选择2020年2月至2021年11月在福建省三明市中西医结合医院行手术治疗的114例患者为研究对象,根据其是否发生PI分为两组,PI组15例,无PI组99例,分析手术室外科手术患者发生PI的相关危险因素。结果单因素分析显示,手术时间、年龄、麻醉方式、体重指数、手术体位、出血量、术中低体温、局部潮湿与手术室外科手术患者发生PI有关,差异有统计学意义(P<0.05);性别、合并基础疾病与手术室外科手术患者发生PI无关,差异无统计学意义(P>0.05);多因素分析显示:年龄≥60岁(β=2.592,OR=13.350,95%CI=3.932~45.330)、手术时间≥4 h(β=3.109,OR=22.400,95%CI=5.639~88.974)、气管内全身麻醉(β=2.760,OR=15.800,95%CI=4.068~61.372)、特殊体位(β=3.627,OR=37.600,95%CI=9.267~152.562)、体重指数≥25 kg/m^(2)(β=2.904,OR=18.250,95%CI=3.856~86.376)、出血量≥80 ml/h(β=2.853,OR=17.333,95%CI=3.668~81.912)、术中低体温(β=1.432,OR=4.187,95%CI=1.322~13.267)、局部潮湿(β=1.649,OR=5.200,95%CI=1.114~24.270)是手术室外科手术患者发生PI的高危因素(P<0.05)。结论手术室外科手术患者发生PI受手术时间、年龄、麻醉方式、体重指数、手术体位、出血量、术中低体温、局部潮湿影响。

Objective To explore the related risk factors of pressure injury(PI)in surgical patients in the operating room.Methods A total of 114 patients who underwent surgery in Sanming Integrated Medicine Hospital from February 2020 to November 2021 were selected by convenient sampling method,and were divided into two groups according to whether they suffered from PI,with 15 cases in the PI group and 99 cases in the non-pressure injury group.The related risk factors of PI in surgical patients in the operating room were analyzed.Results Univariate analysis showed that operation time,age,anesthesia method,body mass index,surgical position,blood loss,intraoperative hypothermia and local moistness were related to the occurrence of PI in surgical patients in the operating room,with statistically significant differences(P<0.05).Gender and combined underlying diseases were not related to PI in surgical patients in the operating room,with no statistically significant differences(P>0.05).Multivariate analysis showed that age≥60(β=2.592,OR=13.350,95%CI=3.932-45.330),operation time≥4 h(β=3.109,OR=22.400,95%CI=5.639-88.974),intratracheal general anesthesia(β=2.760,OR=15.800,95%CI=4.068-61.372),special position(β=3.627,OR=37.600,95%CI=9.267-152.562),body m ass index≥25 kg/m^(2)(β=2.904,OR=18.250,95%CI=3.856-86.376),blood loss≥80 ml/h(β=2.853,OR=17.333,95%CI=3.668-81.912),intraoperative hypothermia(β=1.432,OR=4.187,95%CI=1.322-13.267)and local moistness(β=1.649,OR=5.200,95%CI=1.114-24.270)were the high risk factors of PI in surgical patients in the operating room(P<0.05).Conclusion The PI of surgical patients in the operating room can be affected by operation time,age,anesthesia method,body mass index,surgical position,blood loss,intraoperative hypothermia and local moistness.