问题导向联合压疮预警干预机制在重症脑出血术后昏迷患者中的应用

Application of Problem-oriented Combined with Pressure Ulcer Early Warning Intervention Mechanism in Postoperative Coma Patients with Severe Cerebral Hemorrhage

目的:探讨问题导向联合压疮预警干预机制在重症脑出血术后昏迷患者中的应用效果,为临床护理提供依据。方法:选取2019年6月—2021年5月德阳市人民医院收治的84例重症脑出血术后昏迷患者作为研究对象,按照入院时间先后将其分为对照组和观察组,每组各42例。对照组实施常规护理干预,观察组在常规护理基础上实施问题导向联合压疮预警干预机制。比较两组患者压疮发生风险、压疮发生率及分期、术后临床效果(术后ICU治疗时间、术后机械通气时间)、护理满意度情况。结果:干预3 d后,观察组患者压疮发生风险明显低于对照组,差异有统计学意义(Z=2.299,P<0.05)。观察组患者压疮发生率及压疮分期明显低于对照组,差异有统计学意义(χ^(2)=4.141,P<0.05)。观察组患者术后ICU治疗时间、术后机械通气时间均明显短于对照组,差异有统计学意义(t=7.970、5.813,P<0.05)。干预后,观察组患者护理满意度明显高于对照组,差异有统计学意义(χ^(2)=6.574,P<0.05)。结论:问题导向联合压疮预警干预机制可降低重症脑出血术后昏迷患者的压疮风险,改善压疮情况,促进患者早日康复,提高护理满意度。

Objective:To explore the application effect of problem-oriented combined pressure ulcer early warning intervention mechanism in patients with postoperative coma after severe cerebral hemorrhage,and to provide a basis for clinical care.Methods:84 cases of postoperative coma patients with severe cerebral hemorrhage admitted to the hospital from June 2019 to May 2021 were selected as the study subjects,and they were divided into the control group and the observation group according to the sequence of admission time,with 42 cases in each group.The control group implemented conventional nursing interventions,and the observa-tion group implemented the problem-oriented joint pressure ulcer early warning intervention mechanism on the basis of conventional nursing.The risk of pressure ulcer occurrence,pressure ulcer incidence and staging,postoperative clinical outcomes(postoperative ICU treatment time,postoperative mechanical ventilation time),and nursing satisfaction were compared between the two groups.Results:After 3 d of intervention,the risk of pressure ulcers in the observation group was significantly lower than that in the con-trol group,and the difference was statistically significant(Z=2.299,P<0.05).The incidence rate of pressure ulcers and the stage of pressure ulcers in the observation group were significantly lower than those in the control group,and the difference was statisti-cally significant(χ^(2)=4.141,P<0.05).The postoperative ICU treatment time and postoperative mechanical ventilation time of the observation group were significantly shorter than those of the control group,and the differences were statistically significant(t=7.970,5.813,P<0.05).After the intervention,nursing satisfaction in the observation group was significantly higher than that in the control group,and the difference was statistically significant(χ^(2)=6.574,P<0.05).Conclusion:Problem-oriented combined pres-sure ulcer early warning intervention mechanism can reduce the risk of pressure ulcers in comatose patients after severe cere-bral hemorrhage,improve pressure ulcers,promote patients’early recovery,and improve nursing satisfaction.