动态交替式气垫床联合营养支持对外伤性危重患者压力性损伤预防价值评估

目的 探讨动态交替式气垫床联合营养支持对外伤性危重患者压力性损伤(pressure injury, PI)的预防作用。方法 选取2019年1月—2021年12月在亳州市人民医院急诊外科接受治疗的外伤性危重患者130例，按随机数字表法将其分为观察组和对照组，每组65例。观察组患者行营养支持联合动态交替式气垫床护理，对照组患者行营养支持联合喷气式气垫床护理。观察比较2组患者PI前期表现发生率、PI发生率、昏迷与健康状况及住院时间、住院费用等。结果 治疗7 d后，观察组患者未出现压力性损伤，对照组患者出现压力性损伤1期3例，2组患者的压力性损伤发生率比较差异无统计学意义(P=0.244);治疗后7 d,观察组患者的压力性损伤前期发生率低于对照组(P=0.020)。2组患者Braden评分在时间、组别、时间与组别的交互作用方面差异均有统计学意义。观察组患者治疗5、7 d时的Braden评分高于对照组[(13.87±1.18)分vs.(13.11±1.38)分；(14.79±1.80)分vs.(13.73±1.86)分，均P<0.05],治疗7 d后，观察组患者GCS评分[(8.11±1....

Analysis of the application of dynamic alternating air cushion bed combined with nutritional support to prevent pressure injury in critically ill patients

  Objective  To investigate the preventive effect of dynamic alternating air cushion bed combined with nutritional support on pressure injury in critically ill trauma patients.  Methods  A total of 130 critically ill trauma patients who were treated in our department from January 2019 to December 2021 were selected and randomly divided into observation and control groups according to the number-table method, with 65 cases in each group. Patients in the observation group received nutrition support combined with dynamic alternating air cushion bed care, whereas those in the control group received nutrition support combined with jet cushion care. The incidence of pre- pressure injury manifestations, pressure injury incidence, coma and health status, length of stay and hospitalisation expenses were observed and compared between the two groups.  Results  After 7 d of treatment, no patients in the observation group had developed pressure injury, and 3 patients in the control group had developed pressure injury stage 1. No significant difference existed in the incidence of pressure injury between the two groups (P=0.244). From 7 d of treatment, patients in the observation group had a lower incidence of the stress-injury prophase than those in the control group (P=0.020). Significant differences existed in the Braden score between the two groups in time, group, and interaction between time and group. Patients in the observation group had higher Braden scores than those in the control group at 5 and 7 days of treatment [(13.87±1.18) points vs. (13.11±1.38) points, (14.79±1.80) points vs. (13.73±1.86) points, all P < 0.05]. After 7 days of treatment, the GCS scores [(8.11±1.74) points vs. (6.83±1.43) points] and APACHE Ⅱ scores [(16.68±3.01) points vs. (19.16±3.26) points] in the observation group were significantly better than those in the control group (all P < 0.05). This finding suggested that nutritional support combined with dynamic alternating air cushion bed had a good rehabilitation effect on critically ill traumatic patients.  Conclusion  Nutritional support combined with a dynamic alternating air cushion bed are more effective for stress-injury prevention in critically ill trauma patients and warrants clinical promotion.