某医院2014-2016年住院手术患者手术急性压伤的三间分布情况

目的 了解住院手术患者手术急性压伤的人间、空间、时间分布情况。方法 选取2014—2016年武汉市某三级甲等综合医院住院手术患者作为研究对象,分别进行回顾描述性分析其手术急性压伤的发生率及人间、空间、时间情况。结果 本组住院手术患者手术急性压伤发生率为0.1175%（189/160 775）,Ⅰ期和Ⅱ期压伤,分别为48.7%、51.3%;男性压伤发生率是女性的1.875倍,压伤发生率最高的年龄段为14~18岁;高发体位为俯卧位;好发部位为颜面部、胸部、骶尾部、四肢和髂前上棘（人间）;手术急性压伤的高发专科是神经外科、器官移植和心脏大血管外科、骨科（空间）;压伤高发季度依次为一季度、四季度、二季度、三季度;94%发生压伤的患者,手术时间>4 h（时间）。结论 2014—2016年住院手术患者手术急性压伤发生率低于文献报道、转归良好;住院手术压伤患者以男性、>40岁、14~18岁居多,以俯卧位、颜面部为主;多见于神经外科、器官移植科;多见于第一季度、2月份及手术时间>4 h者。手术室护理人员应结合手术压伤的三间分布及临床特点,进行针对性的手术压伤预防。

Distribution of Population,Time and Space of Crush Injury of Hospitalized Surgical Patients

Objective To understand the distribution of population, time and space of crush injury of hospitalized surgical patients. Methods Hospitalized surgical patients in one tertiary grade-A hospital from 2014 to 2016 were enrolled and the incidence of crush injury and the distribution of population, time and space of crush injury were retrospectively analyzed. Results The incidence of crush injury in the study was 0.1175% (189/160,775) and that of stage I and II crush injury 48.7% and 51.3% respectively. There were 1.875 times of males suffering crush injury as females and the highest incidence of crush injury was found among patients aged from 14 to 18. Prone position was the one with the high risk of crush injury and facial region, chest, sacrococcygeal region, limbs and anterior superior spine witnessed the highest incidence of crush injury. Most crush injuries were found in department of neurosurgery, department of organ transplantation, cardiovascular department and department of orthopedics. The first quarter topped the list of crush injury occurrence, followed by the fourth, second and third quarter and 94% of the patients with crush injury had a surgical time longer than 4 h. Conclusion The incidence of crush injury is lower than that reported among hospitalized surgical patients from 2014 to 2016 and they are with good outcomes. The majority of patients suffering crush injury are males and aged over 40, particularly aged from 14 to 18. Most crush injuries occurred in prone position and facial region. Neurosurgical department and organ transplantation department witnessed the majority of crush injury, which majorly occurs in the first quarter, particularly in February and among patients with surgical time longer than 4h. Nursing staff in operating room should take preventive measures based on the distribution of population, time and space of crush injury and other clinical features.