KPS评分与营养水平对肿瘤患者压力性损伤发生的影响
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摘要
目的探讨KPS评分与营养水平对肿瘤患者发生院内获得性压力性损伤的影响,为临床筛选重点预防对象、采取干预措施提供依据。方法选取2017年1月—2018年1月入住肿瘤内科的恶性肿瘤晚期患者261例,评估患者的一般资料及KPS评分、血清白蛋白、血红蛋白、Braden评分,给予相应的预防措施,每天观察院内获得性压力性损伤的发生情况。结果院内获得性压力性损伤发生率为13. 03%(34/261)。不同KPS评分、年龄、皮肤类型、血清白蛋白、血红蛋白含量、Braden评分患者压力性损伤发生情况差异有统计学意义(P <0. 05)。高龄、KPS评分≤30分、低血清白蛋白、低血红蛋白、Braden评分≤16分患者压力性损伤发生率更高。结论肿瘤患者KPS评分、血清白蛋白、血红蛋白水平与压疮发生密切相关,压疮的高发生率提示晚期肿瘤患者需要早期干预、强化结构化的压力性损伤预防措施。
Objective To investigate the influence of Karnofsky Performance Status scale( KPS) and nutrition levels on pressure injury in cancer patients,and provide evidence for clinical screening of high-risk objects and take intervention measures. Methods A convenient sampling method w as used to select 261 patients w ith advanced malignant tumors w ho w ere admitted to hospital from January 2017 to January 2018. The KPS score,serum albumin,hemoglobin,and Braden scores w ere evaluated. Corresponding prevention measures and the daily observation of hospital-acquired stress injuries w ere carried out in the hospital. Results The incidence of hospital-acquired stress injuries in the hospital w as 13. 03%( 34/261). Univariate analysis show ed that there w ere significant differences in stress injury condition of patients w ith different KPS score,age,type of skin,serum albumin,hemoglobin level and Braden score( P < 0. 05). Patients w ith higher age,KPS score ≤ 30 points,low er serum protein,low er hemoglobin,Braden score ≤ 16 points w ere more vulnerable to the stress injury. Conclusions This study show ed that KPS scores,serum protein,and hemoglobin levels w ere closely related to pressure ulcers. Give the high incidence of pressure ulcers,early intervention and enhanced structural pressure ulcer prevention measures should be carried out for patients w ith advanced cancer.
Objective To investigate the influence of Karnofsky Performance Status scale( KPS) and nutrition levels on pressure injury in cancer patients,and provide evidence for clinical screening of high-risk objects and take intervention measures. Methods A convenient sampling method w as used to select 261 patients w ith advanced malignant tumors w ho w ere admitted to hospital from January 2017 to January 2018. The KPS score,serum albumin,hemoglobin,and Braden scores w ere evaluated. Corresponding prevention measures and the daily observation of hospital-acquired stress injuries w ere carried out in the hospital. Results The incidence of hospital-acquired stress injuries in the hospital w as 13. 03%( 34/261). Univariate analysis show ed that there w ere significant differences in stress injury condition of patients w ith different KPS score,age,type of skin,serum albumin,hemoglobin level and Braden score( P < 0. 05). Patients w ith higher age,KPS score ≤ 30 points,low er serum protein,low er hemoglobin,Braden score ≤ 16 points w ere more vulnerable to the stress injury. Conclusions This study show ed that KPS scores,serum protein,and hemoglobin levels w ere closely related to pressure ulcers. Give the high incidence of pressure ulcers,early intervention and enhanced structural pressure ulcer prevention measures should be carried out for patients w ith advanced cancer.
引文
[1]汤必群.综合护理干预对重症脑外伤术后昏迷患者压力性损伤发生率及预后的影响[J].临床医学研究与实践,2017,2(19):189-190.
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[5]张翠萍,曹艳,康璇.癌痛-压力性损伤规范化管理在恶性肿瘤病人护理中的应用[J].护理研究,2017,31(34):4428-4430.
[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):64-68.
[7] ARTICO M,DANTE A,D'ANGELO D,et a1. Prevalence,incidence and associated factors of pressure ulcers in home palliative care patients:A retrospective chart review[J]. Palliat Med,2018,32(1):299-307.
[8] MOORE Z,JOHANSSEN E,VAN ETTEN M. A review of PU prevalence and incidence across Scandinavia,Iceland and Ireland(Part I)[J]. J Wound Care,2013,22(7):361-362.
[9] BRINK P,SMITH T F,LINKEWICH B. Factors associated with pressure ulcers in palliative home care[J].J palliat med,2006,9(6):1369-1375.
[10] MEHTA C,GEORGE J V,MEHTA Y,et al. Pressure ulcer and patient characteristics--A point prevalence study in a tertiary hospital of India based on the European Pressure Ulcer Advisory Panel minimum data set[J]. J Tissue Viability,2015,24(3):123-130.
[11]蒋琪霞,管晓萍,苏纯音,等.综合性医院压疮现患率多中心联合调研[J].中国护理管理,2013,13(1):26-30.
[12] MAIDA V,LAU F,DOWNING M,et al. Correlation between Braden Scale and Palliative Performance Scale in advanced illness[J]. Int Wound J,2008,5(4):585-590.
[13] LEE Y,KWON O,SHIN C S,et al. Use of bioelectrical impedance analysis for the assessment of nutritional status in critically ill patients[J]. Clin Nutr Res,2015,4(1):32-40.
[2] HENDRICHOVA I,CASTELLI M,MASTROIANNI C,et al. Pressure ulcers in cancer palliative care patients[J]. Palliat Med,2010,24(7):669-673.
[3] MAIDA V,ENNIS M,KUZIEMDKY C,et al. Woundds and survival in cancer patients[J]. Eur J Cancer,2009,45(18):3237-3244.
[4]蒋琪霞,陈月娟,苏纯音,等.多中心医院获得性压疮预防现况及干预对策[J].中华护理杂志,2013,48(8):724-726.
[5]张翠萍,曹艳,康璇.癌痛-压力性损伤规范化管理在恶性肿瘤病人护理中的应用[J].护理研究,2017,31(34):4428-4430.
[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):64-68.
[7] ARTICO M,DANTE A,D'ANGELO D,et a1. Prevalence,incidence and associated factors of pressure ulcers in home palliative care patients:A retrospective chart review[J]. Palliat Med,2018,32(1):299-307.
[8] MOORE Z,JOHANSSEN E,VAN ETTEN M. A review of PU prevalence and incidence across Scandinavia,Iceland and Ireland(Part I)[J]. J Wound Care,2013,22(7):361-362.
[9] BRINK P,SMITH T F,LINKEWICH B. Factors associated with pressure ulcers in palliative home care[J].J palliat med,2006,9(6):1369-1375.
[10] MEHTA C,GEORGE J V,MEHTA Y,et al. Pressure ulcer and patient characteristics--A point prevalence study in a tertiary hospital of India based on the European Pressure Ulcer Advisory Panel minimum data set[J]. J Tissue Viability,2015,24(3):123-130.
[11]蒋琪霞,管晓萍,苏纯音,等.综合性医院压疮现患率多中心联合调研[J].中国护理管理,2013,13(1):26-30.
[12] MAIDA V,LAU F,DOWNING M,et al. Correlation between Braden Scale and Palliative Performance Scale in advanced illness[J]. Int Wound J,2008,5(4):585-590.
[13] LEE Y,KWON O,SHIN C S,et al. Use of bioelectrical impedance analysis for the assessment of nutritional status in critically ill patients[J]. Clin Nutr Res,2015,4(1):32-40.