慢性阻塞性肺疾病患者行无创正压通气发生面部压疮的危险因素分析

Risk Factors of Facial Pressure Ulcers in Patients with Chronic Obstructive Pulmonary Disease Undergoing Noninvasive Positive Pressure Ventilation

目的探讨慢性阻塞性肺疾病(简称“慢阻肺”)患者行无创正压通气发生面部压疮的危险因素分析。方法选择2019年1月至2021年12月期间行无创正压通气治疗的慢阻肺患者200例作为研究对象,将发生面部压疮的50例患者作为观察组,另有150例患者未发生面部压疮作为对照组。对行无创正压通气治疗的慢阻肺患者发生面部压疮进行单因素及多因素分析。结果单因素结果表明:慢阻肺患者行无创正压通气患者发生面部压疮发生率与年龄、营养、压力、累计带机时间、皮肤水肿、温度、意识状态、PCO_(2)水平及皮肤潮湿度有统计意义(P<0.05);多因素Logistic回归分析结果表明:累计带机时间(β=0.393,OR=1.475,95%CI=1.631-5.282)、皮肤水肿(β=0.425,OR=2.104,95%CI=1.261-3.063)、温度(β=0.727,OR=2.612,95%CI=0.17-4.401)、PCO_(2)水平(β=1.439,OR=6.324,95%CI=0.234-2.572)是慢阻肺患者行无创正压通气患者发生面部压疮的独立危险因素(P<0.05)。结论慢阻肺患者行无创正压通气患者发生面部压疮的危险因素较多,明确慢阻肺患者行无创正压通气患者发生面部压疮的影响因素,根据可能存在的影响因素进行针对性的干预,有助于医师及早进行科学合理的治疗。

Objective To explore the risk factors of facial pressure ulcers in patients with chronic obstructive pulmonary disease(COPD)undergoing non-invasive positive pressure ventilation.Methods 200 patients with COPD who received non-invasive positive pressure ventilation from January 2019 to December 2021 were selected as the study subjects,50 patients with facial pressure ulcers were selected as the observation group,and 150 patients without facial pressure ulcers were selected as the control group.Univariate and multivariate analysis of facial pressure ulcers in patients with COPD treated with noninvasive positive pressure ventilation were conducted.Results Unifactor results showed that the incidence of facial pressure ulcers in COPD patients undergoing non-invasive positive pressure ventilation was statistically significant with age,nutrition,pressure,accumulated time of wearing,skin edema,temperature,state of consciousness,PCO_(2)level and skin moisture(P<0.05).Multivariate Logistic regression analysis showed that:Accumulated belt time(β=0.393,OR=1.475,95%CI=1.631-5.282),skin edema(β=0.425,OR=2.104,95%CI=1.261-3.063),temperature(β=0.727,OR=2.612,95%CI=0.17-4.401)and PCO_(2)level(β=1.439,OR=6.324,95%CI=0.234-2.572)were independent risk factors for facial pressure ulcers in COPD patients undergoing non-invasive positive pressure ventilation(P<0.05).Conclusion There are many risk factors for facial pressure ulcers in patients with COPD undergoing non-invasive positive pressure ventilation.To clarify the influencing factors of facial pressure ulcers in patients with COPD undergoing non-invasive positive pressure ventilation and carry out targeted intervention according to the possible influencing factors can help doctors to carry out scientific and reasonable treatment as soon as possible.