手术患者压疮发生率及发生时间和影响因素研究

目的：探讨手术患者压疮发生率、发生时间特点和相关因素，为临床制定应对措施提供依据。方法：按照统一标准在12所综合医院中入选1074例术后患者，预防措施相同，采用“外科压疮风险评估表”收集每例患者术后0～5d基线资料，使用Braden计分量表评估压疮危险。采用Logistic回归分析压疮发生的影响因素。结果：观察期内1074例手术患者中发生11例11处Ⅰ期压疮，发生率1.02%，其中外科监护病房发生率1.95%。多发生在术后1～3d内。压疮发生的影响因素为：手术时间、术后皮肤水肿和使用矫形装置及Braden计分（P〈0.05）。结论：对手术时间≥2h、术后皮肤水肿、使用矫形装置及Braden计分≤16分的患者应作为术后压疮预防的重点对象，但Braden量表对围手术期患者压疮风险的预测作用尚有待于进一步研究。

Pressure ulcer incidence and inlfuencing factors among surgical inpatients in general hospitals

Objective：To analyze the incidence of pressure ulcers and influencing factors among surgical inpatients in general hospitals in order to develop nursing interventions to prevent pressure ulcers. Methods：According to the same inclusion and exclusion criteria, 1,074 surgical patients from 12 general hospitals were enrolled in the study. Each patient was given the same preventive intervention. The researchers collected their Braden scores, blood pressure, medicines and instruments used, numbers and stages of hospital-acquired pressure ulcers （HAPU） according to the＂Surgical pressure ulcer risk assessment questionnaire＂from the operation day to the 5th day after surgery. Multiple stepwise regression analyses were used to analyze the relationship between variables and pressure ulcers. Results：11 patients got 11 sites of stage I pressure ulcers during the observation period, most of which occurred in the 1st~3rd day after surgery. Related factors of pressure ulcers included：surgical procedure time,skin edema at post operation and using orthopedic instruments and Braden scores. Conclusions：Patients with surgical time more than 2 hours in operating room, skin edema at post operation, using orthopedic instruments and Braden score less than 16 points should be the focus of pressure ulcer prevention. Further researches are needed to evaluate the effects of Braden Scale for predicting pressure ulcer risks among surgical inpatients.