重型颅脑损伤术后昏迷患者发生压力性损伤的危险因素分析

Risk factors analysis of pressure injury in postoperative coma patients with severe brain injury

目的分析重型颅脑损伤(SBI)术后昏迷患者发生压力性损伤(PI)的危险因素。方法采用便利抽样法,选取2018年6月—2022年4月河南省人民医院收治的300例SBI术后昏迷患者为研究对象,根据术后7 d是否发生PI将患者分为PI组(n=35)和无PI组(n=265),比较两组患者的临床资料。采用Logistic回归分析SBI术后昏迷患者发生PI的危险因素。结果300例SBI术后昏迷患者住院期间PI发生率为11.67%(35/300),发生PI共54处。Logistic回归分析显示,年龄、糖尿病、营养不良、大小便失禁、呼吸方式、术后高热均是SBI术后昏迷患者发生PI的影响因素(P<0.05)。结论年龄大、有糖尿病、有营养不良、有大小便失禁、机械通气及有术后高热均是SBI术后昏迷患者发生PI的危险因素,护理人员应积极评估患者PI发生风险并给予针对性的预防措施。

Objective To explore the risk factors of pressure injury(PI)in postoperative coma patients with severe brain injury(SBI).MethodsFrom June 2018 to April 2022,300 postoperative coma patients with SBI admitted to Henan Provincial People's Hospital were selected as the study subject by convenience sampling.Patients were divided into PI group(n=35)and non-PI group(n=265)based on whether PI occurred 7 days after surgery,and the clinical data of the two groups of patients were compared.Logistic regression was used to analyze the risk factors for postoperative PI in coma patients with SBI.ResultsAmong 300 postoperative coma patients with SBI,the incidence of PI during hospitalization was 11.67%(35/300),with a total of 54 occurrences of PI.Logistic regression analysis showed that age,diabetes,malnutrition,urinary and fecal incontinence,respiratory mode and postoperative hyperthermia were all the influencing factors of PI in coma patients with SBI after surgery(P<0.05).ConclusionsAge,diabetes,malnutrition,urinary and fecal incontinence,mechanical ventilation and postoperative high fever are all risk factors for PI in coma patients with SBI.Nurses should actively evaluate the risk of PI and provide targeted preventive measures.