摘要
目的探讨腔镜手术患者术中获得性压力性损伤(IAPI)高危影响因素及护理策略。方法选取2021年2月至2023年12月在萍乡市萍矿总医院手术室行腔镜手术治疗的417例患者作为研究对象,其中367例(88.01%)未发生IAPI,将其设为非IAPI组;50例(11.99%)发生IAPI,将其设为IAPI组。比较两组患者的临床资料,采用单因素分析、多因素logistic回归分析法,分析腔镜手术患者发生IAPI的高危影响因素。结果单因素分析结果显示,两组患者的手术体位、体重指数(BMI)、手术时间、有无术中低体温、是否合并低蛋白血症、呼吸方式比较,差异有统计学意义(P<0.05);两组患者的性别、是否使用类固醇药物、年龄、有无吸烟史比较,差异无统计学意义(P>0.05)。多因素分析结果显示,特殊体位(β=1.377,OR=3.965,95%CI:2.146~7.324)、BMI<18.5 kg/m^(2)(β=1.869,OR=6.484,95%CI:2.962~14.195)和>24 kg/m^(2)(β=2.074,OR=7.956,95%CI:3.439~18.404)、手术时间>1 h(β=1.525,OR=4.595,95%CI:2.336~9.039)、术中低体温(β=1.778,OR=5.920,95%CI:3.089~11.346)、合并低蛋白血症(β=1.856,OR=6.398,95%CI:3.275~12.498)、机械通气(β=4.840,OR=126.471,95%CI:49.628~322.291)是腔镜手术患者发生IAPI的独立危险因素(P<0.05)。结论腔镜手术患者发生IAPI与手术体位、BMI、手术时间、术中低体温、合并低蛋白血症、呼吸方式有关,针对上述因素制订护理措施干预,可能减少IAPI发生。
Objective To explore the high-risk influencing factors and nursing strategies for intraoperative acquired pressure injury(IAPI)in patients undergoing laparoscopic surgery.Methods A total of 417 patients who underwent laparoscopic surgery in Operating Room,General Hospital of Pingxiang Mining Group Co.from February 2021 to December 2023 were selected as the research objects.Among them,367 cases(88.01%)did not have IAPI and were set as the non-IAPI group.50 cases(11.99%)had IAPI and were set as IAPI group.The clinical data of the two groups were compared.Univariate analysis and multivariate logistic regression analysis were used to analyze the high-risk influencing factors of IAPI in patients undergoing endoscopic surgery.Results The results of univariate analysis showed that there were statistically significant differences in surgical position,body mass index(BMI),operation time,intraoperative hypothermia,hypoproteinemia,and respiratory mode between the two groups(P<0.05).There were no statistically significant differences in gender,steroid use,age,and smoking history between the two groups(P>0.05).Multivariate analysis showed that special body position(β=1.377,OR=3.965,95%CI:2.146-7.324),BMI<18.5 kg/m^(2)(β=1.869,OR=6.484,95%CI:2.962-14.195)and>24 kg/m^(2)(β=2.074,OR=7.956,95%CI:3.439-18.404),operation time>1 h(β=1.525,OR=4.595,95%CI:2.336-9.039),intraoperative hypothermia(β=1.778,OR=5.920,95%CI:3.089-11.346),combined hypoproteinemia(β=1.856,OR=6.398,95%CI:3.275-12.498)and mechanical ventilation(β=4.840,OR=126.471,95%CI:49.628-322.291)were independent risk factors for IAPI in patients undergoing laparoscopic surgery(P<0.05).Conclusion The occurrence of IAPI in patients undergoing laparoscopic surgery is related to surgical position,BMI,operation time,intraoperative hypothermia,combined hypoproteinemia and respiratory mode.Nursing interventions should be formulated according to the above factors,which may reduce the occurrence of IAPI.
作者
王军
陈水芳
WANG Jun;CHEN Shuifang(Operating Room,General Hospital of Pingxiang Mining Group Co.,Jiangxi Province,Pingxiang 337000,China)
出处
《中国当代医药》
2025年第11期175-178,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202210123)。
关键词
术中获得性压力性损伤
腔镜手术
术中低体温
体重指数
Intraoperative acquired pressure injury
Laparoscopic surgery
Intraoperative hypothermia
Body mass index
