压疮风险预警护理在重症患者压力性损伤中的预防效果

Effect of early warning nursing of pressure ulcer risk on the prevention of pressure injuries in critical patients

目的探讨压疮风险预警护理在重症患者压力性损伤中的预防效果。方法选取2020年3月至2022年3月在厦门医学院附属第二医院重症医学科收治的110例重症患者为研究对象,将其按照随机数字表法分为观察组(56例)和对照组(54例)。对照组采取常规护理方法,观察组在对照组护理方法的基础上采取压疮风险预警护理。比较2组患者的压疮愈合时间、皮肤护理费用、1周内的换药次数和压疮发生情况,以及血清炎症因子和免疫球蛋白水平。结果观察组患者在1周内的换药次数少于对照组,压疮愈合时间早于对照组,皮肤护理费用低于对照组,压疮发生率低于对照组(P均<0.05)。干预2周及1个月后,2组的血清白介素-6(IL-6)、白介素-8(IL-8)和白介素-10(IL-10)水平均低于同组入院当日,免疫球蛋白M(IgM)、免疫球蛋白A(IgA)和免疫球蛋白G(IgG)水平均高于同组入院当日(P均<0.05);观察组的血清IL-6、IL-8和IL-10水平均低于同期对照组,IgM、IgA和IgG水平均高于同期对照组(P均<0.05)。结论压疮风险预警护理模式能及早辨别出压疮高风险患者,并给予应对措施,减少压疮的发生,降低炎症因子水平,避免抵抗力下降而增加感染的风险,从而减轻患者的家庭经济负担。

Objective To explore the effect of early warning nursing of pressure ulcer risk on the prevention of pressure injuries in critical patients.Methods A total of 110 critical patients in the Intensive Care Unit of the Second Affiliated Hospital of Xiamen Medical College from March 2020 to March 2022 were recruited and divided into an observation group(56 cases)and a control group(54 cases)through random number table method.The control group adopted conventional nursing method,and the observation group adopted early warning nursing of pressure ulcer risk on the basis of the control group.The healing time of pressure ulcers,skin care cost,dressing change frequency within 1 week,incidence of pressure ulcers,and serum levels of inflammatory factors and immunoglobulin were compared between the two groups.Results The frequency of dressing change within 1 week in the observation group was less than that in the control group.The healing time of pressure ulcers was shorter than that in the control group.The cost of skin care was lower than that in the control group.The incidence of pressure ulcers was lower than that in the control group(all P<0.05).After 2 weeks and 1 month of intervention,the serum levels of interleukin(IL)-6,IL-8,and IL-10 in both groups were lower than those on the admission day(all P<0.05),and the levels of immunoglobulin(Ig)M,A,and G were higher than those on the admission day(all P<0.05).The observation group had lower levels of IL-6,IL-8,and IL-10 and higher levels of IgM,IgA,and IgG than the control group(all P<0.05).Conclusion Early warning nursing model of pressure ulcer risk can early identify the patients with high risk of pressure ulcers and take measures to reduce the pressure ulcers and inflammatory factor levels,avoid the decline of immunity to infections,and reduce the economic burden of the families.