| 傅伊菲,陈孟珂.重型颅脑损伤患者发生压疮的危险因素分析[J].中国烧伤创疡杂志,2023,(6):429~432. |
| DOI： |
| 中文关键词: 重型颅脑损伤 压疮 Logistic 回归分析 危险因素 |
| 英文关键词:Severe craniocerebral injury Pressure ulcer Logistic regression analysis Risk factors |
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| 中文摘要: |
| 【摘要】 目的 分析探讨重型颅脑损伤患者发生压疮的危险因素。方法 选取2017年1月至2020年1月河南科技大学第一附属医院收治的 188 例重型颅脑损伤患者作为研究对象，收集患者性别、年龄、体重指数(BMI)、是否合并糖尿病、是否合并高血压、有无高度水肿、有无大小便失禁、是否合并营养不良、入院时格拉斯哥昏迷评分 (GCS)、入院时 Braden 压疮风险评估量表 (简称 Braden) 评分、是否留置尿管、是否留置胃管、卧床时间等资料，并根据患者是否发生压疮将其分为压疮组和无压疮组，单因素分析各指标与重型颅脑损伤患者发生压疮的相关性，多因素 Logistic 回归分析重型颅脑损伤患者发生压疮的危险因素。 结果 188例重型颅脑损伤患者中出现压疮62例，设为压疮组；未出现压疮126例，设为无压疮组。单因素分析结果显示，压疮组年龄＞60岁、BMI＞24 kg/m2、有高度水肿、有大小便失禁、合并营养不良、入院时GCS评分＜8分、入院时Braden评分≤12 分、卧床时间≥15 d 的患者比例明显高于无压疮组(χ2= 26.082、20.033、4.707、4.273、4.440、4.343、7.236、7.221，P＜0.001、P＜0.001、P = 0.030、P = 0.039、P = 0.035、P = 0.037、P = 0.007、P = 0.007)。多因素 Logistic 回归分析结果显示，年龄＞60 岁、BMI＞24 kg / m2、合并营养不良以及入院时 Braden评分≤12分是重型颅脑损伤患者发生压疮的独立危险因素 (95% CI 为 1.090～3.190、1.060～3.202、1.024～3.478、1.212～2.805，P= 0.023、0.031、0.042、0.004)。结论 年龄＞60岁、BMI＞24 kg/m2、合并营养不良以及入院时 Braden 评分≤12 分是重症颅脑损伤患者发生压疮的独立危险因素，临床应予以重点关注，及时采取相应干预措施，预防压疮的发生。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the risk factors for pressure ulcer in patients with severe craniocerebral injury.Methods 188 patients with several craniocerebral injury, admitted into The First Affiliated Hospital of Henan University of Science and Technology between January 2017 and January 2020 were enrolled as research subjects, and their data were collected including sex, age, body mass index ( BMI), complicated with diabetes and hypertension or not, with severe edema and incontinence or not, complicated with malnutrition or not, Glasgow coma scale (GCS) scores and Braden scale (Braden) scores on admission, with indwelling urinary catheter and gastric tube or not, and bedridden time, etc. Based onwhether pressure ulcer occurred, the patients were divided into ulcer group and non-ulcer group. Univariate analysis was carried out to evaluate the correlation between these indicators and the occurrence of pressure ulcer in patients with severe
craniocerebral injury, and multivariate Logistic regression analysis was conducted to analyze the risk factors for pressure ulcer in patients with severe craniocerebral injury. Results Among the 188 patients with severe craniocerebral injury, 62 patients developed pressure ulcer, setting as ulcer group, and the other 126 patients without suffering pressure ulcer were set as non-ulcer group. The results of univariate analysis showed that the proportions of patients with age > 60 years, BMI >24 kg / m2, with severe edema and incontinence, complicated with malnutrition, GCS score < 8 points on admission,Braden score ≤ 12 points on admission, bedridden time ≥ 15 days were significantly higher in the ulcer group compared with the non-ulcer group (χ2= 26.082, 20.033, 4.707, 4.273, 4.440, 4.343, 7.236 and 7.221, P < 0.001, P < 0.001, P = 0.030, P = 0.039, P = 0.035, P = 0.037, P = 0.007, P = 0.007). The results of multivariate Logistic regression analysis showed that, age > 60 years, BMI > 24 kg / m2 , complicated with malnutrition and Braden score ≤ 12 points on admission were independent risk factors associated with the occurrence of pressure ulcer in patients with severe craniocerebral injury (95% CI: 1.090 - 3.190, 1.060 - 3.202, 1.024 - 3.478, 1.212 - 2.805, P = 0.023, 0.031,0.042 and 0.004). Conclusion Age > 60 years, BMI > 24 kg / m2, complicated with malnutrition and Braden score ≤12 points on admission were independent risk factors associated with the occurrence of pressure ulcer in patients with severe craniocerebral injury. Special attention and effective interventions should be paid and taken in clinical practice in a timely fashion to prevent the occurrence of pressure ulcer. |
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