可控压体位垫结合测压仪在预防术中获得性压力性损伤中的应用研究

Application of controlled pressure position pad combined with manometer in preventionof intraoperative acquired stress injury

目的 观察可控压体位垫在预防平卧位手术术中获得性压力性损伤(IAPI)中的应用效果。方法 选取2022年1-10月我院收治的预计手术时间>3 h的120例平卧位手术患者为研究对象,按随机数字表法分为观察组和对照组各60例。对照组使用凝胶垫加棉垫和泡沫敷料,术中巡回护士徒手给予患者骶尾部局部减压;观察组采用可控压体位垫加棉垫和泡沫敷料,术前使用测压仪评估患者骶尾部悬空需要的充气值,术中每隔2 h体位垫充气至预设值,悬空骶尾部保持30 min,放气恢复原体位。比较2组患者IAPI的发生率、医生及护士工作满意度。结果 观察组未发生IAPI,对照组发生IAPI 5例,2组比较差异有统计学意义(P<0.05);术中医生满意度调查结果:观察组满意度为86.7%,对照组满意度为16.7%,差异有统计学意义(P<0.001);术中护士工作满意度调查显示观察组满意度为80%,对照组的满意度为41.7%,差异有统计学意义(P<0.001)。结论 可控压体位垫结合测压仪的应用,可提高巡回护士术中对患者受压部位进行减压的积极性,降低平卧位手术患者IAPI的发生率,提高护理质量。

Objective To observe the application effect of controlled pressure position pad in supine patients with intraoperative acquired stress injury(IAPI).Method A total of 120 patients operated on in the supine position with expected operation time>3 h who were admitted to our hospital from January to October 2022 were selected as the research objects,and were then divided into observation group and control group according to the random number table method,with 60 cases in each group.In the control group,gel pad,cotton pad,and foam dressing were used,and local decompression of caudal-sacral part was given by traveling nurses during the operation.In the observation group,controlled pressure position pad was added with cotton pad and foam dressing,preoperative manometer was used to evaluate the aeration value required by caudal-sacral suspension of patients,and the position pad was inflated to the preset value every 2 h during the operation,the sacrococcygeal region was suspended for 30 min and then deflated to return to the original position.The incidence of IAPI,doctors'and nurses'job satisfaction were compared between the two groups.Results There were no IAPI in the observation group and 5 cases in the control group,the difference was statistically significant(P<0.05);The satisfaction of doctors was 83.3%in the observation group and 16.7%in the control group,and the difference was statistically significant(P<0.001);In the survey of nurses'job satisfaction,the satisfaction of the observation group was 80%and that of the control group was 41.7%,the difference was statistically significant(P<0.001).Conclusion The application of controlled pressure position pad combined with manometer can improve the enthusiasm of circuit nurses to decompress the compressed parts of patients during operation,reduce the incidence of IAPI in patients undergoing surgery in supine position,and improve the quality of care.