腹腔镜胃肠道患者手术中发生压力性损伤的影响因素分析

doi:10.3969/j.issn.1006-5253.2020.01.004

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目的探讨腹腔镜胃肠道手术中压力性损伤的影响因素。方法选择2016年10月至2019年5月于本院行腹腔镜胃肠道手术治疗的214例患者作为观察对象，回顾性分析患者临床资料，统计压力性损伤发生率，经logistic回归分析法分析腹腔镜胃肠道手术中压力性损伤发生危险因素。结果 214例行腹腔镜胃肠道手术治疗患者术中并发压力性损伤26例，发生率是12.15%，包括1期压力性损伤19例、2期压力性损伤2例、深部组织损伤5例；单因素分析：腹腔镜胃肠道手术中压力性损伤发生和患者术中体位移动、呼吸方式、受压部位皮肤状况、手术时间存在相关性，差异有统计学意义（P＜0.05）；腹腔镜胃肠道手术中压力性损伤发生和患者性别、年龄、BMI指数、吸烟史、应用类固醇药物无相关性，差异无统计学意义（P＞0.05）；多因素logistic回归分析：患者术中体位移动(OR=1.594)、呼吸方式(OR=2.765)、受压部位皮肤异常(OR=3.452)、手术时间≥1 h (OR=1.234)为腹腔镜胃肠道手术中压力性损伤发生独立危险因素，差异有统计学意义（P＜0.05）。结论腹腔镜胃肠道手术患者术中存在一定压力性损伤发生危险性，而患者术中体位移动、呼吸方式、受压部位皮肤异常、手术时间≥1h是导致腹腔镜胃肠道手术中压力性损伤发生独立危险因素，故需进一步制定有针对性的应对策略，避免压力性损伤发生，确保患者生命健康。 

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	陈淑淑
	蔡玉洁
	黄越超

关键词 ：腹腔镜胃肠道手术, 压力性损伤, 危险因素, 预防干预

Abstract：Objective To explore the influencing factors of pressure injury in laparoscopic gastrointestinal surgery.Methods Totally 214 cases of patients who underwent laparoscopic gastrointestinal surgery in our hospital from October 2016 to May 2019 were enrolled in this study. Patients' clinical data were retrospectively analyzed, to investigate the incidence of stress injury, and to analyze the risk factors of pressure injury in laparoscopic gastrointestinal surgery with logistic regression analysis.Results Among the 214 patients who underwent laparoscopic gastrointestinal surgery, 26 cases of concurrent stress injury occurred during the operation, and the incidence rate was 12.15%, including 19 cases of stage 1 pressure injury, 2 cases of stage 2 pressure injury, and 5 cases of deep tissue injury. Univariate analysis showed that there was a correlation between the occurrence of pressure injury in laparoscopic gastrointestinal surgery and the movement of the body during surgery, breathing method, skin condition of the compression site, and operation time with significant statistical differences (P<0.05). There was no correlation between the occurrence of stress injury in laparoscopic gastrointestinal surgery and gender, age, BMI index, smoking history, and steroid use without significant statistical differences (P>0.05). Multivariate logistic regression analysis showed that the patients' intraoperative position shift (OR=1.594), breathing method (OR=2.765), skin abnormalities at the compression sites (OR=3.452), and one-hour operation time and above (OR=1.234) were independent risk factors for pressure injury in laparoscopic gastrointestinal surgery (P<0.05).Conclusion There is a certain risk of pressure injury in patients undergoing laparoscopic gastrointestinal -surgery. The movement of the body during the operation, breathing method, abnormal skin at the compression site, and one-hour operation time and above are independent risk factors for stress injury in laparoscopic gastrointestinal surgery. So it is necessary to further develop specific coping strategies to avoid the occurrence of stress injuries and ensure the health of patients.

Key words： laparoscopic gastrointestinal surgery stress injury risk factor preventive intervention

收稿日期: 2019-10-01

通讯作者: 陈淑淑,Email:zmy89566@163.com

引用本文:

陈淑淑,蔡玉洁,黄越超. 腹腔镜胃肠道患者手术中发生压力性损伤的影响因素分析[J]. 中国医院统计, 2020, 27(1): 28-31.
Chen Shushu, Cai Yujie, Huang Yuechao.. Analysis of influencing factors of pressure injury in laparoscopic gastrointestinal patients during operation. journal1, 2020, 27(1): 28-31.

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