ICU患者医疗器械相关性压力性损伤发生特征及影响因素分析

Analysis of characteristics and influencing factors of medical device related pressure injury in ICU patients

目的了解重症监护室(ICU)患者医疗器械相关性压力性损伤(MDRPI)发生特征,探讨其相关影响因素。方法选取2021年6月至12月新疆医科大学第一附属医院ICU患者280例,依据是否发生MDRPI将其分为发生组和未发生组。比较两组一般资料、临床资料及器械使用情况,采用多因素logistic回归分析ICU患者发生MDRPI的影响因素。结果55例发生了MDRPI,发生率为19.6%。两组年龄、Braden量表评分、急性生理与慢性健康评分表Ⅱ(APACHEⅡ)评分、ICU类型、手术、俯卧位通气、意识障碍、使用血管活性药、使用镇静药物、肠内营养、血红蛋白、ICU停留时间、医疗器械使用情况比较,差异有统计学意义(P<0.05)。年龄、俯卧位通气、APACHEⅡ评分、血红蛋白>120 g/L、医疗器械使用总数、使用无创通气面罩是ICU患者发生MDRPI的影响因素(P<0.05)。结论ICU患者可因高龄、俯卧位通气、病情危重、医疗器械总数多、使用无创通气面罩等而易发生MDRPI。护理人员应对患者进行全面评估,预见性给予预防措施,以减少MDRPI的发生。

Objective To understand the characteristics of medical device related pressure injury(MDRPI) in intensive care unit(ICU) patients, and to analyze its influencing factors. Methods A total of 280 ICU patients admitted to the First Affiliated Hospital of Xinjiang Medical University from June to December 2021 were selected. According to the occurrence of MDRPI, they were divided into occurrence group and non-occurrence group. The general data, clinical data, and device use of two groups were compared, and multivariate logistic regression was used to analyze the influencing factors. Results MDRPI occurred in 55 cases, with an incidence of 19.6%. There were significant differences in age, Braden scale score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, ICU type, operation, prone position ventilation,disturbance of consciousness, use of vasoactive drugs, use of sedatives, enteral nutrition, hemoglobin, ICU stay time, and total number of medical device use between two groups(P <0.05). Age, prone position ventilation, APACHE Ⅱ score,hemoglobin >120 g/L, total number of medical devices used, and use of non-invasive ventilation mask were the influencing factors for MDRPI in ICU patients(P<0.05). Conclusion ICU patients may be prone to MDRPI due to age, prone position ventilation, critical condition, large number of medical devices used, and use of non-invasive ventilation masks. The nursing staff should conduct a comprehensive assessment of the patient and give preventive measures in anticipation to reduce the occurrence of MDRPI.