【作者】 陈洁；

【导师】 徐静娟；

【作者基本信息】 苏州大学 ， 护理学， 2016， 硕士

【摘要】 研究目的比较分析两种不同气垫床结合不同翻身间隔时间对重型颅脑损伤压疮高危患者的预防效果,寻求最佳结合点,为临床压疮预防方案的制定提供理论依据。研究方法将180例重症颅脑患者按SPSS生成的随机数字表法分为A、B、C、D、E、F六组,ABC为喷气式气垫床组,翻身间隔时间分别为q2h、q3h、q4h;DEF为动态交替式气垫床组,翻身间隔时间分别为q2h、q3h、q4h。观察72h,每次翻身时观察患者皮肤压疮发生情况及压疮前期表现,分析压疮前期表现患者的影响因素。研究结果1.六组患者的压疮发生率无明显差异(P>0.05);2.六组患者压疮前期表现组内比较差异有统计学意义;6组进行两两比较,24h内不同气垫床配合相同翻身时间A组与D组无统计学差异,χ~2=0.534,P>0.05,B组与E组、C组与F组均有统计学差异,分别为χ~2=7.937,P<0.05;χ~2=3.774,P<0.05;48h内不同气垫床配合相同翻身时间A组与D组无统计学差异,χ~2=0.010,P>0.05,B组与E组、C组与F组均有统计学差异,分别为χ~2=7.177,P<0.05;χ~2=5.079,P<0.05;72h内不同气垫床配合相同翻身时间A组与D组无统计学差异,χ~2=1.090,P>0.05,B组与E组、C组与F组均有统计学差异,分别为χ~2=11.429,P<0.05;χ~2=4.444,P<0.05;结论为医疗用喷气式气垫床配合3h、4h翻身间隔的压疮前期表现比动态交替式气垫床配合3h、4h翻身间隔发生率高。3.六组患者发生压疮前期表现的影响因素为年龄>60岁和组别为医疗用喷气式气垫床。研究结论重症颅脑损伤患者应用两种气垫床均能有效预防压疮,并且动态交替式气垫床可以延长至4 h翻身1次,既可以减轻护士的工作量,又对压疮的形成无不良影响。更多还原

【Abstract】 Objective:Aimed to improve the quality and efficiency of care by evaluating the effectiveness and feasibility of two kinds of air mattresses and different repositioning interval in patients with severe traumatic brain injury.Methods:180 cases of severe traumatic brain injury patients who were at high risk of pressure ulcer were recruited in this research. They were randomlyassigned into six groups by SPSS generated random number table: A、B、C、D、E and F. The A、B and C groups accepted the static air mattress and the repositioning interval was 2h 、 3h and 4h respectively, while the D、E and F groups accepted the dynamic alternating air mattress and the repositioning interval was 2h、3h and 4h respectively. The incidence of pressure ulcer and pressure ulcer pre-performance(mild skin redness can fade performance or reduced pressure after 30 minutes) were recorded before each reposition during the observation of 72 h. Nurses assessed the risk factors of the pressure ulcer during the every 8 hours.Results:1. No significant difference was observed in the incidence of pressure ulcer between six groups(p>0.05).2. There were significant difference between six groups after the same observation period. By comparing the incidences of pressure ulcer pre-performance after 24 h, 48 h and 72 h in two groups with the same reposition interval time: B vs E、C vs F, we found that the pressure ulcer pre-performance was more frequently occurred in the group using the static air mattress respectively.As follows:within 24 h,B vs E χ~2=7.937,P<0.05;C vs F χ~2=5.079,P<0.05;within 48 h,B vs E χ~2=7.177,P<0.05;C vs F χ~2=5.079,P<0.05;within 72 h,B vs Eχ~2=11.429,P<0.05;C vs F χ~2=4.444,P<0.05;3. The age( >60 years) and mattress type(static air mattress) were the risk factors of pressure ulcers pre-performance.Conclusion:Both types of the air mattresses can effectively prevent pressure ulcer inpatients with severe traumatic brain injury. The repositioning interval can be extended to 4 hours if the patients lying on the dynamic alternating air mattress, that means lightening the workload of nursing staff without increasing the incidence of pressure ulcer.更多还原