心血管疾病手术患者术中压疮的动态评估及预防研究

摘要

目的 降低心血管疾病手术患者术中压疮发生率.方法 采用自行设制的3S手术患者压疮高危因素评估表对2 913例心血管疾病手术患者进行术中压疮高危因素评估,对存在术中压疮高危因素的362例(12.43％)患者于手术过程中进行动态评估及针对性防护干预.结果 362例患者中发生术中压疮40例(1.37％),术后72 h发生压疮3例(0.10％);较长空腹时间及受压局部皮肤状况不佳是术中压疮发生的主要危险因素(OR=2.770、3.194,均P＜0.01).结论 应用3S手术患者压疮高危因素评估表对心血管疾病手术患者进行动态评估和实施针对性防护,可有效降低术中压疮发生率.对空腹时间较长及受压部位皮肤状况不佳者需进一步改进防护措施.%Objective To reduce the incidence of intraoperative pressure ulcer for patients with cardiovascular disease.Methods The high risk factors of intraoperative pressure ulcer were assessed in 2 913 patients with cardiovascular disease using a self-designed 3S high risk factors of intraoperative pressure ulcer for surgery patients,then dynamic assessment and preventive intervention were carried out for 362 (12.43 ％) patients with high risk factors during the operation.Results Totally 40 (1.37 ％) of the 362 patients suffered intraoperative pressure ulcer,and 3 (0.10％) patients suffered pressure ulcer at 72 h after the operation.Long fasting time and poor local skin condition were the main risk factors of intraoperative pressure ulcer (OR=2.770,3.194,P＜0.01 for both).Conclusion Application of the 3S high risk factors of intraoperative pressure ulcer for surgery patients to conduct dynamic assessment and targeted preventive intervention for patients with cardiovascular disease,can effectively reduce the incidence of intraoperative pressure ulcer.It is necessary to improve the preventive measures further for the patients with a long time of fasting and poor skin condition.