急诊老年病人压力性损伤的危险因素分析

doi:10.3969/j.issn.1003-9198.2022.07.022

摘要/Abstract

摘要： 目的探讨急诊老年病人发生压力性损伤的危险因素,为采取预防护理措施提供指导。方法选取2020年6月至2021年5月于南京梅山医院急诊治疗的90例老年病人为研究对象,收集病人的人口学资料、合并症及生化结果,使用Braden量表对其进行压力性损伤风险评估。每日观察病人压力性损伤的发生情况直至其离开急诊科,采用二分类Logistic回归分析急诊老年病人发生压力性损伤的危险因素。结果 90例急诊老年病人中发生压力性损伤15例(16.67％),发生组与未发生组的入急诊时间、白蛋白水平、Braden量表总评分、营养状况评分、摩擦力和剪切力评分差异均有统计学意义(P＜0.05)。多因素Logistic回归分析显示,Braden量表总分低、白蛋白水平低是急诊老年病人发生压力性损伤的危险因素。结论急诊护理人员应及时监测老年病人的白蛋白水平,并根据Braden量表评分采取有针对性的预防护理措施,降低急诊老年病人压力性损伤的发生率。

关键词: Braden量表, 急诊老年病人, 压力性损伤, 危险因素

Abstract: Objective To explore the risk factors of pressure injury in the emergency elderly patients, and to provide the guidance for taking preventive nursing measures. Methods A total of 90 elderly patients admitted to the Emergency Department of Nanjing Meishan Hospital from June 2020 to May 2021 were enrolled in this study. The demographic data, comorbidities and biochemical results of the patients were collected. The risk of pressure injury in the emergency elderly patients was assessed by Braden scale, and the occurrence of pressure injury was observed daily until the patients left the Emergency Department. The risk factors of pressure injury in the emergency elderly patients were analyzed by binary Logistic regression. Results There were 15 patients presenting with pressure injury, with an incidence rate of 16.67%. There were statistically significant differences in the time of emergency admission, albumin level, Braden scale total score, nutritional status score, friction and shear force score between the occurrence group and the non-occurrence group (P<0.05). Multivariate Logistic regression analysis showed that low Braden scale total score and low albumin level were the risk factors of pressure injury in the emergency elderly patients. Conclusions Emergency nurses should timely monitor the level of albumin in the elderly patients, and take targeted preventive nursing measures according to the score of Braden scale, so as to reduce the incidence of pressure injury in the emergency elderly patients.

Key words: Braden scale, emergency elderly patient, pressure injury, risk factor

中图分类号:

R642

张利, 赵青, 李金林. 急诊老年病人压力性损伤的危险因素分析[J]. 实用老年医学, 2022, 36(7): 741-744.

ZHANG Li, ZHAO Qing, LI Jin-lin. Analysis of risk factors for pressure injury in emergency elderly patients[J]. Practical Geriatrics, 2022, 36(7): 741-744.

参考文献

[1] SKOGESTAD I J, MARTINSEN L, BØRESETING T E, et al. Supplementing the Braden scale for pressure ulcer risk among medical inpatients: the contribution of self-reported symptoms and standard laboratory tests[J]. J Clin Nurs, 2017, 26(1/2):202-214.
[2] PACHA H H P, FARIA J I L, DE OLIVERIRA K A, et al. Pressure ulcer in Intensive Care Units: a case-control study[J]. Rev Bras Enferm, 2018, 71(6):3027-3034.
[3] ANRYS C, VAN TIGGELEN H, VERHAEGHE S, et al. Independent risk factors for pressure ulcer development in a high-risk nursing home population receiving evidence-based pressure ulcer prevention: results from a study in 26 nursing homes in Belgium[J]. Int Wound J, 2019, 16(2):325-333.
[4] 黄灿, 马玉霞, 蒋梦瑶, 等. 压力性损伤风险评估工具的研究进展[J]. 上海护理, 2021, 21(1):50-53.
[5] 贾静, 罗彩凤, 孙婧, 等. Munro与Braden压疮评估表用于手术患者压疮评估预测效度比较[J]. 护理学杂志, 2017, 32(18):57-61.
[6] 王晓, 蒋云芬, 邱霞, 等. 基于Braden评分的专项护理在腰椎骨折患者压力性损伤中的应用[J]. 齐鲁护理杂志, 2021, 27(10):2275-2278.
[7] 陈秀芳, 周爱妹, 卢素娟, 等. 两种量表评分在老年脑血管意外患者压力性损伤风险评估中的效果比较[J]. 温州医科大学学报, 2021, 51(6):502-505.
[8] BERGSTROM N, BRADEN B J, LAGUZZA A, et al. The Braden scale for predicting pressures pressure sore risk[J]. Nurs Res, 1987, 36(4):205-210.
[9] 邓欣, 吕娟, 陈佳丽, 等. 2016年最新压疮指南解读[J]. 华西医学, 2016, 31(9):1496-1498.
[10] 张亚杰, 于波心, 李铁刚. 急诊老年患者的综合管理[J]. 中国急救复苏与灾害医学杂志, 2019, 14(8):787-791.
[11] 何凌霄, 袁震飞, 刘欢, 等. 急诊患者压力性损伤现状及预防的研究进展[J]. 解放军护理杂志, 2021, 38(10):65-68.
[12] LIU P, SHEN W Q, CHEN H L. The incidence of pressure ulcers in the emergency department: A Meta-analysis[J]. Wounds, 2017, 29(1):14-19.
[13] HOLMES R, MACCHIANO K, JHANGIANI S S, et al. Nutrition know-how. Combating pressure sores—nutritionally[J]. Am J Nurs, 1987, 87(10):1301-1303.
[14] 石佳佳, 李贤, 许文清, 等. 血清白蛋白与肌红蛋白对ICU患者早期压力性损伤的预测价值[J]. 护士进修杂志, 2021, 36(23):2198-2200.
[15] 卢亚运, 胡爱玲. 压力性损伤相关性疼痛的护理研究进展[J]. 护理研究, 2017, 31(23):2831-2834.
[16] 赵静, 吴金凤, 李菁, 等. OH 压力性损伤评估表在老年患者压力性损伤危险预测中的应用[J]. 中国护理管理, 2017, 17(11):1500-1503.
[17] 霍婉君, 冯素云, 曾繁端, 等. ICU患者压疮危险因素的Meta分析[J]. 齐鲁护理杂志, 2018, 24(24):35-39.
[18] 潘文亮. 压力性损伤早期防护在脑卒中患者中的应用效果的相关因素分析[D]. 合肥:安徽医科大学, 2019.