深部组织压力性损伤评估与预防的研究进展
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摘要
对深部组织压力性损伤评估与预防两方面进行总结。量化评估技术包括超声检测、皮肤水分含量测试、激光多普勒血流检测及皮肤热成像检测4项;预防措施包括采用多种评估工具综合应用以提高评估准确性,预防性使用减压工具及辅助治疗等减少深部组织压力性损伤的发生,以期为临床护理早发现、早干预提供参考。
引文
[1] 黄秋霞,王建宁,汤利萍,等.支撑用具预防压力性损伤的研究现状[J].护理学杂志,2018,33(1):97-100.
[2] Black J M,Edsberg L E,Baharestani M M,et al.Pressure ulcers:avoidable or unavoidable?Results of the National Pressure Ulcer Advisory Panel Consensus Confe-rence[J].Ostomy Wound Manage,2011,57(2):24-37.
[3] Ayello E A,Delmore B,Smart H,et al.Survey results from the Philippines:NPUAP changes in pressure injury terminology and definitions[J].Adv skin wound care,2018,31(1):601-606.
[4] National Pressure Ulcer Advisory Panel.Consensus conference on pressure ulcer staging[R].Chicago:National Pressure Ulcer Advisory Panel,2016.
[5] Beeckman D,Schoonhoven L,Fletcher J,et al.EPUAP classification system for pressure ulcers:European reliability study[J].J Adv Nurs,2007,60(6):682-691.
[6] 褚万立,郝岱峰.美国国家压疮咨询委员会2016年压力性损伤的定义和分期解读[J].中华损伤与修复杂志(电子版),2018,13(1):68-72.
[7] 王泠,郑小伟,马蕊,等.国内外失禁相关性皮炎护理实践专家共识解读[J].中国护理管理,2018,18(1):3-6.
[8] Quintavalle P R,Lyder C H,Mertz P J,et al.Use of high-resolution,high-frequency diagnostic ultrasound to investigate the pathogenesis of pressure ulcer development[J].Adv Skin Wound Care,2006,19(9):498-505.
[9] Aoi N,Yoshimura K,Kadono T,et al.Ultrasound assessment of deep tissue injury in pressure ulcers:possible prediction of pressure ulcer progression[J].J Plast Reconstr Aesthet Surg,2009,124(2):540-550.
[10] Kanno N,Nakamura T,Yamanaka M,et al.Low-echoic lesions underneath the skin in subjects with spinal-cord injury[J].Spinal Cord,2009,47(3):225-229.
[11] Porter-Armstrong A P,Catherine A,Moorhead A S,et al.Do high frequency ultrasound images support clinical skin assessment?[J].ISRN Nurs,2013,2013(1):1-5.
[12] Deprez J F,Brusseau E,Fromageau J,et al.On the potential of ultrasound elastography for pressure ulcer early detection[J].Med Phys,2011,38(4):1943-1950.
[13] 黄丽,孙建明,许红艳.彩色多普勒超声仪在评估深部组织损伤期压疮中的应用[J].浙江创伤外科,2017,22(5):1009-1010.
[14] Guihan M,Bates-Jenson B M,Chun S,et al.Assessing the feasibility of subepidermal moisture to predict erythema and stage 1 pressure ulcers in persons with spinal cord injury:a pilot study[J].J Spinal Cord Med,2012,35(1):46-52.
[15] Harrow J J,Mayrovitz H N.Subepidermal moisture surrounding pressure ulcers in persons with a spinal cord injury:a pilot study[J].J Spinal Cord Med,2014,37(6):719-728.
[16] Mayrovitz H N,Bernal M,Brlit F,et al.Biophysical measures of skin tissue water:variations within and among anatomical sites and correlations between mea-sures[J].Skin Res Technol,2013,19(1):47-54.
[17] Park S,Kim C G,Ko J W.The use of sub-epidermal moisture measurement in predicting blanching erythema in jaundice patients[J].J Wound Care,2018,27(5):342-349.
[18] Kim C G,Park S,Ji W K,et al.The relationship of subepidermal moisture and early stage pressure injury by visual skin assessment[J].J Tissue Viability,2018,27(3):130-135.
[19] Bates-Jensen B M,Mccreath H E,Nakagami G,et al.Subepidermal moisture detection of heel pressure injury:the pressure ulcer detection study outcomes[J].Int Wound J,2017,15(2):35-39.
[20] Liao F,Jan Y K.Using multifractal detrended fluctuation analysis to assess sacral skin blood flow oscillations in people with spinal cord injury[J].J Rehabil Res Dev,2011,48(7):787-801.
[21] Liao F,Burns S,Jan Y K.Skin blood flow dynamics and its role in pressure ulcers[J].J Tissue Viability,2013,22(2):25-36.
[22] Liao F,Garrison D W,Jan Y K.Relationship between nonlinear properties of sacral skin blood flow oscillations and vasodilatory function in people at risk for pressure ulcers[J].Microvasc Res,2010,80(1):44-53.
[23] Jan Y K,Struck B D,Foreman R D,et al.Wavelet analysis of sacral skin blood flow oscillations to assess soft tissue viability in older adults[J].Microvasc Res,2009,78(2):162-168.
[24] Verhonick P J,Lewis D W,Goller H O.Thermography in the study of decubitus ulcers:preliminary report[J].Nurs Res,1972,21(3):233-237.
[25] Judy D,Brooks B,Fennie K,et al.Improving the detection of pressure ulcers using the TMI ImageMed system[J].Adv Skin Wound Care,2011 ,24(1):18-24.
[26] Yanagi H,Terashi H,Takahashi Y,et al.The Japanese registry for surgery of ischial pressure ulcers:STANDARDS-I[J].J Wound Care,2018,27(3):174-183.
[27] Nakagami H,Sugimoto K,Ishikawa T,et al.Physician-initiated clinical study of limb ulcers treated with a functional peptide,SR-0379:from discovery to a rando-mized,double-blind,placebo-controlled trial[J].NPJ Aging Mech Dis,2018,4(1):2-4.
[28] Cereda E,Klersy C,Andreola M,et al.Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing[J].Clin Nutr,2017,36(1):246-252.
[29] Cereda E,Neyens J C L,Caccialanza R,et al.Efficacy of a disease-specific nutritional support for pressure ulcer healing:a systematic review and meta-analysis[J].J Nutr Health Aging,2016,35(6):S118-S119.
[30] Warner J,Ann Raible M,Hajduk G,et al.Best practices for pressure ulcer prevention in the burn center[J].Crit Care Nurs Q,2017,40(1):41-48.
[31] 姜丽萍,张恩,罗旭.支撑性工具在压疮防治中的循证评价[J].中华护理杂志,2009,44(12):1148-1150.
[32] 胡玮.压力缓解性羊皮床垫在临床护理中的应用效果[J].医学信息,2015,33(45):279-280.
[33] 陈洁,徐静娟,景新华,等.不同气垫床翻身间隔时间预防重型颅脑损伤患者压疮效果比较[J].护理学杂志,2016,31(14):48-51.
[34] Stotts N A,Hopf H W,Kayser-Jones J,et al.Increased fluid intake does not augment capacity to lay down new collagen in nursing home residents at risk for pressure ulcers:a randomized,controlled clinical trial[J].Wound Repair Regen,2010,17(6):780-788.
[35] Black J,Baharestani M,Cuddigan J,et al.National Pressure Ulcer Advisory Panel′s updated pressure ulcer sta-ging system[J].Dermatol Nurs,2007,19(4):343-349.
[36] 唐月学,曾志.不同剂量胰岛素外敷治疗压疮疗效观察[J].中国康复理论与实践,2007,13(11):1090.
[37] 董兴刚,张敏,冯健,等.中药金疮油膏治疗难治性压疮临床疗效观察[J].中国中西医结合杂志,2017,37(2):155-159.
[38] 钱玉华.复方Ⅱ号活血酊剂治疗压疮的效果观察[J].中华护理杂志,2006,41(2):177-178.
[39] 杨少玲.创面负压治疗对糖尿病足创面肉芽组织成纤维细胞影响的研究[D].北京:中国人民解放军医学院,2017.
[40] 洪霞,江雪英,罗烨,等.艾灸盒温灸预防缺血性脑卒中患者压疮效果探讨[J].护理学杂志,2016,31(3):47-49.
[41] Sameem M,Au M,Wood T,et al.A systematic review of complication and recurrence rates of musculocuta-neous,fasciocutaneous,and perforator-based flaps for treatment of pressure sores[J].J Plast Reconstr Aesthet Surg,2012,130(1):67-77.
[42] Durovi A,Mari D,Brdareski Z,et al.The effects of polarized light therapy in pressure ulcer healing[J].Vojnosanit Pregl,2008,65(12):906-912.
[43] Ho C H,Bensitel T,Wang X,et al.Pulsatile lavage for the enhancement of pressure ulcer healing:a randomized controlled trial[J].Phys Ther,2012,92(1):38-48.
[44] 牟静,孙年怡,陈莎莎,等.体外冲击波联合微电流治疗压疮的临床观察[J].成都中医药大学学报,2015,38(1):55-58.
[2] Black J M,Edsberg L E,Baharestani M M,et al.Pressure ulcers:avoidable or unavoidable?Results of the National Pressure Ulcer Advisory Panel Consensus Confe-rence[J].Ostomy Wound Manage,2011,57(2):24-37.
[3] Ayello E A,Delmore B,Smart H,et al.Survey results from the Philippines:NPUAP changes in pressure injury terminology and definitions[J].Adv skin wound care,2018,31(1):601-606.
[4] National Pressure Ulcer Advisory Panel.Consensus conference on pressure ulcer staging[R].Chicago:National Pressure Ulcer Advisory Panel,2016.
[5] Beeckman D,Schoonhoven L,Fletcher J,et al.EPUAP classification system for pressure ulcers:European reliability study[J].J Adv Nurs,2007,60(6):682-691.
[6] 褚万立,郝岱峰.美国国家压疮咨询委员会2016年压力性损伤的定义和分期解读[J].中华损伤与修复杂志(电子版),2018,13(1):68-72.
[7] 王泠,郑小伟,马蕊,等.国内外失禁相关性皮炎护理实践专家共识解读[J].中国护理管理,2018,18(1):3-6.
[8] Quintavalle P R,Lyder C H,Mertz P J,et al.Use of high-resolution,high-frequency diagnostic ultrasound to investigate the pathogenesis of pressure ulcer development[J].Adv Skin Wound Care,2006,19(9):498-505.
[9] Aoi N,Yoshimura K,Kadono T,et al.Ultrasound assessment of deep tissue injury in pressure ulcers:possible prediction of pressure ulcer progression[J].J Plast Reconstr Aesthet Surg,2009,124(2):540-550.
[10] Kanno N,Nakamura T,Yamanaka M,et al.Low-echoic lesions underneath the skin in subjects with spinal-cord injury[J].Spinal Cord,2009,47(3):225-229.
[11] Porter-Armstrong A P,Catherine A,Moorhead A S,et al.Do high frequency ultrasound images support clinical skin assessment?[J].ISRN Nurs,2013,2013(1):1-5.
[12] Deprez J F,Brusseau E,Fromageau J,et al.On the potential of ultrasound elastography for pressure ulcer early detection[J].Med Phys,2011,38(4):1943-1950.
[13] 黄丽,孙建明,许红艳.彩色多普勒超声仪在评估深部组织损伤期压疮中的应用[J].浙江创伤外科,2017,22(5):1009-1010.
[14] Guihan M,Bates-Jenson B M,Chun S,et al.Assessing the feasibility of subepidermal moisture to predict erythema and stage 1 pressure ulcers in persons with spinal cord injury:a pilot study[J].J Spinal Cord Med,2012,35(1):46-52.
[15] Harrow J J,Mayrovitz H N.Subepidermal moisture surrounding pressure ulcers in persons with a spinal cord injury:a pilot study[J].J Spinal Cord Med,2014,37(6):719-728.
[16] Mayrovitz H N,Bernal M,Brlit F,et al.Biophysical measures of skin tissue water:variations within and among anatomical sites and correlations between mea-sures[J].Skin Res Technol,2013,19(1):47-54.
[17] Park S,Kim C G,Ko J W.The use of sub-epidermal moisture measurement in predicting blanching erythema in jaundice patients[J].J Wound Care,2018,27(5):342-349.
[18] Kim C G,Park S,Ji W K,et al.The relationship of subepidermal moisture and early stage pressure injury by visual skin assessment[J].J Tissue Viability,2018,27(3):130-135.
[19] Bates-Jensen B M,Mccreath H E,Nakagami G,et al.Subepidermal moisture detection of heel pressure injury:the pressure ulcer detection study outcomes[J].Int Wound J,2017,15(2):35-39.
[20] Liao F,Jan Y K.Using multifractal detrended fluctuation analysis to assess sacral skin blood flow oscillations in people with spinal cord injury[J].J Rehabil Res Dev,2011,48(7):787-801.
[21] Liao F,Burns S,Jan Y K.Skin blood flow dynamics and its role in pressure ulcers[J].J Tissue Viability,2013,22(2):25-36.
[22] Liao F,Garrison D W,Jan Y K.Relationship between nonlinear properties of sacral skin blood flow oscillations and vasodilatory function in people at risk for pressure ulcers[J].Microvasc Res,2010,80(1):44-53.
[23] Jan Y K,Struck B D,Foreman R D,et al.Wavelet analysis of sacral skin blood flow oscillations to assess soft tissue viability in older adults[J].Microvasc Res,2009,78(2):162-168.
[24] Verhonick P J,Lewis D W,Goller H O.Thermography in the study of decubitus ulcers:preliminary report[J].Nurs Res,1972,21(3):233-237.
[25] Judy D,Brooks B,Fennie K,et al.Improving the detection of pressure ulcers using the TMI ImageMed system[J].Adv Skin Wound Care,2011 ,24(1):18-24.
[26] Yanagi H,Terashi H,Takahashi Y,et al.The Japanese registry for surgery of ischial pressure ulcers:STANDARDS-I[J].J Wound Care,2018,27(3):174-183.
[27] Nakagami H,Sugimoto K,Ishikawa T,et al.Physician-initiated clinical study of limb ulcers treated with a functional peptide,SR-0379:from discovery to a rando-mized,double-blind,placebo-controlled trial[J].NPJ Aging Mech Dis,2018,4(1):2-4.
[28] Cereda E,Klersy C,Andreola M,et al.Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing[J].Clin Nutr,2017,36(1):246-252.
[29] Cereda E,Neyens J C L,Caccialanza R,et al.Efficacy of a disease-specific nutritional support for pressure ulcer healing:a systematic review and meta-analysis[J].J Nutr Health Aging,2016,35(6):S118-S119.
[30] Warner J,Ann Raible M,Hajduk G,et al.Best practices for pressure ulcer prevention in the burn center[J].Crit Care Nurs Q,2017,40(1):41-48.
[31] 姜丽萍,张恩,罗旭.支撑性工具在压疮防治中的循证评价[J].中华护理杂志,2009,44(12):1148-1150.
[32] 胡玮.压力缓解性羊皮床垫在临床护理中的应用效果[J].医学信息,2015,33(45):279-280.
[33] 陈洁,徐静娟,景新华,等.不同气垫床翻身间隔时间预防重型颅脑损伤患者压疮效果比较[J].护理学杂志,2016,31(14):48-51.
[34] Stotts N A,Hopf H W,Kayser-Jones J,et al.Increased fluid intake does not augment capacity to lay down new collagen in nursing home residents at risk for pressure ulcers:a randomized,controlled clinical trial[J].Wound Repair Regen,2010,17(6):780-788.
[35] Black J,Baharestani M,Cuddigan J,et al.National Pressure Ulcer Advisory Panel′s updated pressure ulcer sta-ging system[J].Dermatol Nurs,2007,19(4):343-349.
[36] 唐月学,曾志.不同剂量胰岛素外敷治疗压疮疗效观察[J].中国康复理论与实践,2007,13(11):1090.
[37] 董兴刚,张敏,冯健,等.中药金疮油膏治疗难治性压疮临床疗效观察[J].中国中西医结合杂志,2017,37(2):155-159.
[38] 钱玉华.复方Ⅱ号活血酊剂治疗压疮的效果观察[J].中华护理杂志,2006,41(2):177-178.
[39] 杨少玲.创面负压治疗对糖尿病足创面肉芽组织成纤维细胞影响的研究[D].北京:中国人民解放军医学院,2017.
[40] 洪霞,江雪英,罗烨,等.艾灸盒温灸预防缺血性脑卒中患者压疮效果探讨[J].护理学杂志,2016,31(3):47-49.
[41] Sameem M,Au M,Wood T,et al.A systematic review of complication and recurrence rates of musculocuta-neous,fasciocutaneous,and perforator-based flaps for treatment of pressure sores[J].J Plast Reconstr Aesthet Surg,2012,130(1):67-77.
[42] Durovi A,Mari D,Brdareski Z,et al.The effects of polarized light therapy in pressure ulcer healing[J].Vojnosanit Pregl,2008,65(12):906-912.
[43] Ho C H,Bensitel T,Wang X,et al.Pulsatile lavage for the enhancement of pressure ulcer healing:a randomized controlled trial[J].Phys Ther,2012,92(1):38-48.
[44] 牟静,孙年怡,陈莎莎,等.体外冲击波联合微电流治疗压疮的临床观察[J].成都中医药大学学报,2015,38(1):55-58.