“微移动”在预防仰卧位手术患者术中骶尾部获得性压力性损伤中的效果研究

Study on the effect of"micro movement"in preventing sacrococcygeal intraoperative acquired pressure injury in patients undergoing surgery in supine position

目的观察“微移动”在预防仰卧位手术患者术中骶尾部获得性压力性损伤中的临床效果。方法选取树兰(杭州)医院进行择期仰卧位手术的患者200例,随机分为观察组100例、对照组100例。对照组患者骶尾部覆盖硅胶泡沫软敷料,观察组在此基础上给予“微移动”,即每隔1 h,轮流向左或向右变换手术床15°,持续5 min。比较两组患者术中骶尾部获得性压力性损伤的发生率和骶尾部皮肤相对温差。结果观察组100例中有2例发生IAPI(均为Ⅰ期),对照组100例中有10例发生IAPI(其中Ⅰ期8例、Ⅱ期2例),比较差异有统计学意义(χ^(2)=4.344,P=0.037);观察组骶尾部皮肤相对温差为0(-0.1,0.1)℃,对照组为0.2(-0.2,0.4)℃,比较差异有统计学意义(Z=-3.661,P<0.001)。结论“微移动”可降低仰卧位手术患者术中骶尾部获得性压力性损伤发生率及骶尾部皮肤相对温差。

Objectives To observe the clinical effect of"micro movement"in preventing sacrococcygeal intraoperative acquired pressure injury(IAPI)in patients undergoing surgery in supine position.Methods Totally 200 patients under elective surgery in Shulan(Hangzhou)Hospital were recruited for the study.They were randomly divided into two groups with 100 in the trial group and 100 in the control group.For the control group patients,soft silicone foam dressings were applied to the sacrococcygeal region.On the basis of the treatment for the control group patients,"micro movement"was implemented for the trial group patients.During this process,the operating table was tilted for 15°leftwards and rightwards alternately every 1 h,and the tilt angle was maintained for 5 min.Comparisons between the two groups were made in terms of the IAPI incidence and relative temperature differences on the sacrococcygeal skin.Results There were 2 out of 100 cases in the trial group developed IAPI(both in stage Ⅰ),while 10 out of 100 cases in the control group developed IAPI(including 8 in stageⅠand 2 in stage Ⅱ),with statistically significant differences(χ^(2)=4.344,P=0.037).The relative temperature difference on the sacrococcygeal skin among the trial group and the control group was 0(-0.1,0.1)℃ and 0.2(-0.2,0.4)℃,with statistical significance(Z=-3.661,P<0.001).Conclusion The implementation of"micro movement"during surgery in supine position can reduce the incidence of IAPI and the relative temperature difference on the sacrococcygeal skin in patients undergoing surgery in supine position.