侧卧位开胸术患者术中压疮的危险因素分析与护理对策

目的探讨侧卧位开胸术患者术中发生皮肤急性压疮的高危因素，并提出相应的护理对策。方法回顾124例侧卧位开胸术患者的术前基础资料和术中资料，比较分析手术过程中发生皮肤压疮的26例患者和无压疮的98例患者的年龄、质量指数、血清总蛋白、血红蛋白、血糖、Braden评分、手术持续时间、术中低血压持续时间、低血氧饱和度持续时间、术中出血量、输液量等因素与压疮的相关性。结果侧卧位开胸术患者术中压疮发生率为20．96％，最常见部位为腋下侧胸壁，占50．O％；单因素分析发现除年龄因素外的10个因素均与压疮发生有密切关系（P〈0．05）；Logistic多元回归分析提示手术持续时间、Braden评分和术中出血量是术中压疮发生最重要的危险因素（P〈0．05）。结论手术时间、Braden评分和出血量是侧卧位开胸术患者术中急性压疮发生的独立高危因素，制定针对性的护理对策可降低术中压疮的发生。

The risk factors analysis on acute pressure ulcer during lateral thoracotomy and nursing strategy

Objective To assess the high risk factors of acute pressure ulcer （APU） during lateral thoracotomy, and to put forward the corresponding nursing strategy. Methods The preoperative base data and intraoperative data of 124 patients with lateral thoraeotomy were analyzed retrospectively. 26 patients with APU during lateral thoracotomy were set into APU group, another 98 patients no APU were set into control group. The factors of age, quality index, serum total protein, hemoglobin, blood glucose, Braden score, duration of operation,intraoperative hypotension duration, low oxygen saturation duration, amount of intraoperative bleeding and transfusion amount in two groups were comparatively analyzed retrospectively. Results The APU incidence rate of APU 124 patients with lateral thoracotomy was 20.96%. The most common site of APU was subaxillary lateral chest wall （50.00%）. Single factor analysis revealed that 10 factors （except age factor） were significantly related with the incidence of APU（t~〉2. 16, P 〈 0. 05）. Logistic regression analysis showed only the factors of operation duration, Braden score and the amount of intraoperative bleeding were the most important risk factors （P 〈 0. 05）. Conclusions The factors of operation duration, Braden score and the amount of intraoperative bleeding are the independent risk factors with the incidence of intraoperative APU. Formulating targeted nursing strategies could reduce the occurrence of APU during lateral thoracotomy.