成人体表慢性难愈性创面的相关危险因素分析

Analysis of Risk Factors Related to Chronic Skin Wounds in Adults

目的:分析成人体表慢性难愈性创面发生的相关危险因素。方法:采取病例对照研究法,通过问卷调查收集笔者医院2021年1月-2022年5月收治的203例体表创面患者的一般情况、生活习惯和临床资料,根据1个月内创面是否愈合或出现愈合倾向的标准将患者分为慢性创面组和对照组。采用二元Logistic回归分析模型,分析慢性创面发生的危险因素。结果:共计纳入体表创面患者203例,其中慢性创面组100例,对照组103例。慢性创面组中27%为术后伤口不愈,为最常见的慢性创面类型;多因素分析结果显示:每日吸烟>10支[P=0.016,OR=3.414,95%CI(1.260~9.253)]、洗澡间隔时间>3天/次[P=0.027,OR=3.198,95%CI(1.141~8.966)]、糖尿病[P=0.023,OR=3.575,95%CI(1.190~10.739)]及创面感染[P=0.001,OR=4.098,95%CI(1.813~9.265)]是慢性创面发生的独立危险因素;而适量饮酒[P=0.015,OR=0.332,95%CI(0.136~0.810)]和经常参加体育锻炼[P=0.031,OR=0.431,95%CI(0.201~0.924)]是慢性创面发生的保护性因素。结论:吸烟人群、洗澡频率较低人群及糖尿病患者创面易发生延迟愈合,创面感染容易导致慢性创面发生,而适量饮酒、经常参加体育锻炼能够预防慢性创面发生。

Objective To analyze the risk factors of chronic wounds on adult body surface.Methods Researchers conducted a case-control study,including 203 patients of skin wounds admitted to the Author's Hospital from January 2021 to May 2022.Patients were classified into chronic wounds group and control group according to the criteria of whether the wound healed or showed a tendency to heal within one month.Questionnaire survey were used to collect the general information,living habits and clinical data of patients.The data were screened by Logistic regression analysis to effectively analyze the independent risk factors of chronic skin wounds.Results A total of 203 patients were involved,including 100 patients with chronic wounds and 103 patients in the control group.27%of the chronic wounds were postoperative nonhealing wounds,which was the most common type.The results of multivariate analysis showed that smoking cigarettes more than 10/day[P=0.016,OR=3.414,95%CI(1.260-9.253)],shower every 3 days or more[P=0.027,OR=3.198,95%CI(1.141-8.966)],diabetes mellitus[P=0.023,OR=3.575,95%CI(1.190-10.739)],and infection[P=0.001,OR=4.098,95%CI(1.813-9.265)]were independent risk factors of chronic wounds.Moderate drinking[P=0.015,OR=0.332,95%CI(0.136-0.810)]and regular physical exercising[P=0.031,OR=0.431,95%CI(0.201-0.924)]are protective factors of chronic wounds.Conclusion Smokers,people with low shower frequency and diabetes patients are prone to delayed wound healing.Infected wounds are prone to develop into chronic wounds.Moderate drinking and regular physical exercise can prevent chronic wounds.