手术相关压疮发生危险因素及水胶体敷料衬垫的应用价值

Risk factors foRpressure ulcers in surgically treated patients and the application value of hydrocolloid dressing liner

目的探讨手术相关压疮发生危险因素及水胶体敷料衬垫的应用价值。方法选取2019年1月至2021年3月进行四肢手术患者1000例,按随机双盲法分为2组,使用水胶体敷料作为气压止血带衬垫患者纳入试验组(500例),将使用普通棉质敷料作为衬垫患者纳入对照组(500例),比较2组手术相关性压疮发生情况,并用Logistic回归分析压疮发生的危险因素。结果试验组手术相关性压疮发生率(2.60%)低于对照组(8.60%),创口愈合、直接与间接护理时间均短于对照组(P<0.05)。多因素纳入Logistic回归分析,老年患者、合并基础病症、保护性材质、牵引复位操作、骨科医疗器械使用、低血红蛋白水平、手术俯卧/牵引/截石位、术中低体温、手术时间是手术相关性压疮发生的危险因素。结论手术患者相关压疮发生危险因素众多,包括年龄、手术时间、手术体位、合并基础疾病等,采用水胶体敷料衬垫用于气压止血带处,可相应减少手术相关性压疮的发生,有一定的应用价值。

Objective To investigate the risk factors foRpressure ulcers in surgically treated patients and the application value of hydrocolloid dressing liner.Methods A total of 1000 patients who underwent limb surgery in ouRhospital from January 2019 to March 2021 were randomly divided into two groups by double-blind method.Patients who received hydrocolloid dressing as pneumatic tourniquets were included in the experimental group(n=500),and those who received common cotton dressing as pneumatic tourniquets were included in the control group(n=500).The incidence of surgery-related pressure ulcers was compared between the two groups,and the risk factors foRpressure ulcers were analyzed by Logistic regression.Results The incidence of surgery-related pressure ulcers in the experimental group was significantly loweRthan that in the control group(2.60%vs 8.60%),and the time of wound healing and direct and indirect nursing was significantly shorteR(P<0.05).Multivariate Logistic regression analysis showed that elderly people,underlying diseases,protective materials,traction reduction,use of orthopedic medical instruments,low hemoglobin level,surgical prone/traction/lithotomy position,intraoperative hypothermia,and operation time were the risk factors foRsurgery-related pressure ulcers.Conclusion There are many risk factors foRpressure ulcers in surgically treated patients,including age,operation time,operation position,underlying diseases,etc.The use of hydrocolloid dressing lineRfoRpressure ulcers at the pressure tourniquet can reduce the incidence of surgery-related pressure ulcers,which has a certain application value.