摘要
目的探讨老年胃肠道肿瘤患者手术压力性损伤的影响因素与干预对策。方法选择2015年2月至2018年1月老年胃肠道肿瘤手术后发生压力性损伤的患者68例作为研究组,手术后未发生压力性损伤的患者70例作为对照组,比较两组患者的肿瘤组织学类型、手术类型、辅助治疗、慢性疾病史的情况,术前Braden压力性损伤风险评分及手术时间、住院时间、微型营养评估量表(MNA),并进行老年胃肠道肿瘤手术压力性损伤的多因素Logistic回归分析。结果两组患者的肿瘤组织学类型、手术类型、辅助治疗、慢性疾病史比较差异均无统计学意义(P>0. 05)。研究组患者术前Brade压力性损伤风险评分及总分均低于对照组,差异具有统计学意义(P <0. 05);两组患者移动能力评分比较差异无统计学意义(P> 0. 05)。研究组患者手术时间、住院时间均长于对照组(P <0. 05),MNA评分低于对照组,差异均有统计学意义(P <0. 05)。经多因素Logistic回归分析显示,感知能力、潮湿程度、营养摄取能力、摩擦力和剪切力、住院时间、MNA评分是老年胃肠道肿瘤手术患者压力性损伤的独立危险因素(P <0. 05),活动能力、手术时间是其混杂因素(P> 0. 05)。结论皮肤感知能力较低、潮湿、营养不良、摩擦力和剪切力评分低及住院时间较长是导致老年胃肠道肿瘤手术患者发生压力性损伤的危险因素,实施对症干预,能显著控制压力性损伤的发生,促进老年患者早日康复。
Objective To explore the influencing factors and intervention strategies for surgical pressure injury in elderly patients with gastrointestinal cancer. Methods To select 68 cases of patients with pressure injury after gastrointestinal tumor surgery in our hospital from February 2015 to January 2018 as the study group. A total of 70 cases of patients who didn't have pressure injury after the surgery were selected as the control group. The neoplasms histologic type, type of surgery, adjuvant therapy, history of chronic disease, preoperative Braden stress risk score, operation time, hospitalization time, and mini nutritionaal assessment (MNA) of the patients in the two groups were compared. Besides, multivariate Logistic regression analysis of pressure injury in elderly patients with gastrointestinal tumor surgery were conducted. Results There was no significant difference in neoplasms histologic type, type of surgery, adjuvant therapy and history of chronic disease between the two groups( P >0.05).The risk scores and total scores of pre-operation Brade's stress injury in the study group were lower than that in the control group,and the difference was statistically significant(P<0.05). There was no significant statistical difference in the mobility scores of patients between the two groups(P>0.05). The operation time and hospitalization time of the study group were longer than those of the control group(P<0.05), and the MNA score was lower than that of the control group,and the difference was statistically significant(P<0.05). Multivariate Logistic regression analysis showed that sensory ability, humidity level, nutrient intake capacity, friction and shear force, hospitalization time, and MNA score were independent risk factors for stress injury in elderly patients with gastrointestinal tumor surgery(P<0.05). Activity ability and surgery time were confounding factors( P >0.05). Conclusion Low skin perception, dampness, malnutrition, low scores of friction and shear force, and long hospital stay are risk factors for stress injury in elderly patients with gastrointestinal cancer surgery. If we can apply symptomatic intervention, we can control the occurrence of stress injury significantly, thus promoting the recovery of elderly patients as soon as possible.
作者
苏梅芳
洪菁
周桂兰
廖桂兰
唐友娟
SU Mei-fang;HONG Jing;ZHOU Gui-lan;LIAO Gui-lan;TANG You-juan
出处
《护理实践与研究》
2019年第8期9-12,共4页
Nursing Practice and Research
基金
广西医药卫生自筹经费计划课题项目(Z2015392)
关键词
胃肠道肿瘤
压力性损伤
影响因素
干预对策
Gastrointestinal cancer
Stress injury
Influencing factors
Intervention strategies
