肝移植压疮高危因素分析
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摘要
目的探讨同种异体原位肝移植术后患者发生皮肤压疮的相关危险因素和护理对策,以指导临床对于压疮的预防及处理。方法回顾性分析某院2017年1月-2017年12月收治的117例行同种异体肝移植术患者的临床资料,筛选出术后发生皮肤压疮的病例33例为压疮组,其余84例为对照组,对2组一般资料、术中情况和皮肤压疮的相关危险因素进行单因素分析。对有统计学意义的危险因素进行回归分析,确定患者出现皮肤压疮的危险因素。结果压疮组和对照组患者体重(P=0.000)、术前白蛋白水平(P=0.008)、Braden评分(P=0.000)和手术时间(P=0.000)、糖尿病(P=0.048)、术前腹水(P=0.02)等的差异具有统计学意义(P<0.05),是压疮高相关性因素,经过Logistics回归分析发现患者的体重(P=0.000,OR=1.56)、术前白蛋白水平(P=0.002,OR=0.80)、Braden评分(P=0.001,OR=0.66)和手术时间(P=0.001,OR=2.68),是术后发生皮肤压疮的独立危险因素。结论患者的体重、术前白蛋白水平、Braden评分和手术时间是肝移植患者术后发生皮肤压疮的主要危险因素。针对这些危险因素应制定相应的护理措施,减少患者皮肤压疮发生率,提高患者生活质量。
Objective To explore the risk factors and nursing countermeasures of skin pressure ulcers after orthotopic liver transplantation(olt), so as to guide the prevention and treatment of pressure ulcers. Methods A retrospective analysis of a hospital in January 2017 to December 2017 were the clinical data of 117 patients who underwent allograft liver transplantation, skin ulcer cases occurred after 33 patients for pressure ulcers group, the remaining 84 cases as control group, the two groups of general data, intraoperative situation and skin associated risk factors in single factor analysis of pressure ulcers. Regression analysis of statistically significant risk factors was performed to determine the risk factors for cutaneous pressure sores. Results Pressure sores weight group and control group patients(P = 0.000)(P = 0.008), preoperative albumin level, Braden score(P = 0.000) and operative time(P = 0.000), diabetes(P = 0.048), preoperative ascites(P = 0.02), and other differences statistically significant(P<0.05), it is high pressure sores correlation factors, through the Logistics regression analysis found that the patient's body weight(P = 0.000, OR = 1.56), preoperative albumin levels(P = 0.002, OR=0.80), Braden score(P=0.001, OR=0.66) and operative time(P=0.001, OR=2.68) are independent risk factors for the occurrence of cutaneous pressure ulcers after surgery. Conclusions body weight, preoperative albumin level, Braden score and operative time are the main risk factors for skin pressure ulcers after liver transplantation. In view of these risk factors, corresponding nursing measures should be developed to reduce the incidence of skin pressure sores in patients and improve the quality of life of patients.
Objective To explore the risk factors and nursing countermeasures of skin pressure ulcers after orthotopic liver transplantation(olt), so as to guide the prevention and treatment of pressure ulcers. Methods A retrospective analysis of a hospital in January 2017 to December 2017 were the clinical data of 117 patients who underwent allograft liver transplantation, skin ulcer cases occurred after 33 patients for pressure ulcers group, the remaining 84 cases as control group, the two groups of general data, intraoperative situation and skin associated risk factors in single factor analysis of pressure ulcers. Regression analysis of statistically significant risk factors was performed to determine the risk factors for cutaneous pressure sores. Results Pressure sores weight group and control group patients(P = 0.000)(P = 0.008), preoperative albumin level, Braden score(P = 0.000) and operative time(P = 0.000), diabetes(P = 0.048), preoperative ascites(P = 0.02), and other differences statistically significant(P<0.05), it is high pressure sores correlation factors, through the Logistics regression analysis found that the patient's body weight(P = 0.000, OR = 1.56), preoperative albumin levels(P = 0.002, OR=0.80), Braden score(P=0.001, OR=0.66) and operative time(P=0.001, OR=2.68) are independent risk factors for the occurrence of cutaneous pressure ulcers after surgery. Conclusions body weight, preoperative albumin level, Braden score and operative time are the main risk factors for skin pressure ulcers after liver transplantation. In view of these risk factors, corresponding nursing measures should be developed to reduce the incidence of skin pressure sores in patients and improve the quality of life of patients.
引文
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[3]刘志华,丁俊琴,孟稳利,等.肝移植患者急性压疮发生的危险因素分析[J].中华现代护理杂志,2014,20(16):1916-1919.
[4]余红梅,叶娟,叶啟发,等.肝移植术后急性压疮与慢性压疮发生的高危因素分析及护理对策[J].武汉大学学报(医学版),2016,37(4):666-669.
[5]汪蓉蓉,何重香,贺学宇,等.肝移植手术患者压疮预防效果的Meta分析[J].中华现代护理杂志,2016,22(27):3878-3883.
[6]丁宗励,陈建辉.运用多元Cox回归模型分析影响慢性阻塞性肺疾病合并侵袭性肺曲霉菌病的危险因素[J].中国医刊,2016,51(11):79-81.
[7]缪洁,刘志华,赵金彩,等.综合护理方法对围手术期肝移植患者并发症和生活质量的影响[J].山东医药,2013,53(9):44-45.