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

徐欢; 霍蕊; 许婉红; 李慧

doi:10.16766/j.cnki.issn.1674-4152.002664

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

doi: 10.16766/j.cnki.issn.1674-4152.002664

徐欢¹,
霍蕊²,
许婉红¹,
李慧^1, ,

1.
亳州市人民医院急诊外科，安徽亳州 236800
2.
蚌埠医学院第一附属医院胃肠外科, 安徽蚌埠 233004

基金项目:

安徽高校人文社会科学研究项目 SK2020A0365

详细信息

通讯作者:
李慧, E-mail: BZSRMYYJZWK@163.com

中图分类号: R473.6
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- 被引次数: 0
出版历程
- 收稿日期: 2022-04-11
- 网络出版日期: 2022-11-29

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

XU Huan¹,
HUO Rui²,
XU Wan-hong¹,
LI Hui^{1
, ,}

1.
Department of Emergency Surgery, Bozhou People's Hospital, Bozhou, Anhui 236800, China

摘要

摘要: 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±1.74)分vs.(6.83±1.43)分]及APACHEⅡ评分[(16.68±3.01)分vs.(19.16±3.26)分，均P＜0.05]显著优于对照组，提示营养支持联合动态交替式气垫床对外伤性危重患者具有较好的康复作用。结论营养支持联合动态交替式气垫床对外伤性危重患者压力性损伤预防效果更优，值得临床推广。
- 压力性损伤 /
- 营养支持 /
- 动态交替式气垫床 /
- 预防 /
- 外伤性危重患者
Abstract: 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.
- Stress injury /
- Nutritional support /
- Dynamic alternating air bed /
- Prevention /
- Critically ill traumatic patients

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图 1 2组外伤性危重患者不同时间段PI前期发生情况比较

Figure 1. Comparison of pre-PI occurrence in two groups of critically ill traumatic patients at different time periods

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表 1 2组外伤性危重患者临床资料比较

Table 1. Comparison of clinical data between two groups of traumatic critical patients

组别	例数	性别(例)		年龄(x±s，岁)	BMI(x±s)	入院Braden评分(x±s，分)	糖尿病[例(%)]	糖尿病病程(x±s，年)
组别	例数	男性	女性	年龄(x±s，岁)	BMI(x±s)	入院Braden评分(x±s，分)	糖尿病[例(%)]	糖尿病病程(x±s，年)
观察组	65	49	16	51.17±14.54	23.49±3.41	12.36±1.02	22(33.85)	4.93±1.44
对照组	65	47	18	55.68±12.64	23.32±3.26	12.69±1.30	21(32.31)	4.92±1.73
统计量		0.159^a		1.887^b	0.291^b	1.610^b	0.035^a	0.036^b
P值		0.690		0.061	0.772	0.109	0.852	0.972
注：^a为χ²值，^b为t值。

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表 2 2组外伤性危重患者不同时间段Braden评分比较(x±s，分)

Table 2. Comparison of Braden scores in two groups of critically injured patients at different time periods (x±s, points)

组别	例数	治疗前	治疗1 d	治疗3 d	治疗5 d	治疗7 d	F值	P值
观察组	65	12.36±1.02	12.29±1.05	13.28±1.92^ab	13.87±1.18^abc	14.79±1.80^abcd	34.008	< 0.001
对照组	65	12.69±1.30	12.34±1.17	12.82±1.82	13.11±1.38^bd	13.73±1.86^abcd	7.298	< 0.001
t值		-1.604	-0.230	1.383	3.375	3.324
P值		0.111	0.818	0.169	0.001	0.001
注：与同组治疗前比较，^aP＜0.05;与同组治疗1 d比较，^bP＜0.05;与同组治疗3 d比较，^cP＜0.05;与同组治疗5 d比较，^dP＜0.05。

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表 3 2组外伤性危重患者不同时间段昏迷与健康状况比较(x±s，分)

Table 3. Comparison of coma and health status of critically injured patients in different time periods between 2 groups (x±s, points)

组别	例数	GCS		APACHEⅡ
组别	例数	治疗前	治疗后第7天	治疗前	治疗后第7天
观察组	65	5.39±1.08	8.11±1.74	22.59±4.06	16.68±3.01
对照组	65	5.22±1.41	6.83±1.43	21.77±4.29	19.16±3.26
t值		0.772	4.582	1.119	4.506
P值		0.442	< 0.001	0.265	< 0.001

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