无创正压通气患者发生鼻面部压疮危险因素的回顾性分析

目的:探讨分析无创正压通气(non-invasive positive pressure ventilation,NPPV)患者的鼻面部压疮发生情况及相关危险因素,为制定针对性的预防护理措施提供有效依据.方法:采用1∶1的病例-对照研究方法,通过查阅电子病历和护理记录收集患者在一般人口学特征、营养和疾病一般状况、无创正压通气使用情况以及鼻面部压疮发生情况等资料,采用Logistic回归性分析探讨影响持续无创正压通气患者鼻面部压疮发生的危险因素.结果:173名NPPV患者中发生鼻面部压疮的患者为48例(27.7％),其中Ⅰ期压疮为17例(9.8％),Ⅱ期压疮为30例(17.3％),Ⅲ期压疮为1例(0.6％);Logistic回归分析结果显示,年龄、Glasgow评分、SAS评分、血清白蛋白量、PaO2水平、面部水肿情况、NPPV使用方式、使用NPPV总时间、使用减压保护贴、糖尿病低血压、使用类固醇类药物和使用心血管活性药物是持续无创正压通气患者发生鼻面部压疮的影响因素.结论:鼻面部压疮是持续无创正压通气患者的常见并发症,临床护士可根据患者的具体情况及相关影响因素进行预防性护理,避免鼻面部压疮的发生.

Retrospective analysis on risk factors of pressure sores on noses and faces of patients with non-invasive positive pressure ventilation

Objectives:To discuss and analyze the occurrence of pressure sores on noses and faces of patients with non-invasive positive pressure ventilation (NPPV) and the related risk factors,and to provide effective references for working out targeted preventive and nursing intervention.Methods:A 1 ∶ 1 case-control research method was adopted.General demographic characteristics,general nutrition and illness conditions,NPPV use conditions and occurrence of pressure sores on noses and faces,etc.were collected via looking up the electronic medical records and nursing records.Logistic regression analysis was adopted to analyze and discuss the risk factors of pressure sores on noses and faces of patients with continuous NPPV.Results:Forty-eight out of 173 NPPV patients had pressure sores on noses and faces (27.7％);specifically,17 patients had 1st-stage pressure sores (9.8％),30 patients had 2nd-stage pressure sores (17.3％) and 1 patient had 3rd-stage pressure sores (0.6％).As indicated by the Logistic regression analysis results,the influence factors for pressure sores on noses and faces of the patients with continuous NPPV were as follows:age,Glasgow score,SAS score,serum albumin amount,PaO2 level,face edema,NPPV usage method,total NPPV usage time,usage of pressure reduction protective pastes,diabetes hypotension,usage of steroid medicines and usage of cardiovascular activity medicines.Conclusion:Pressure sore on noses and faces is a common complication among patients with continuous NPPV.The clinical nurses can conduct preventive nursing,according to the specific conditions of the patients and related influence factors,to avoid the occurrence of pressure sores on nose and face.