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手术室皮肤管理在骨科患者术后压疮预防中的应用

作者:罗朝晖 李木卫

所属单位:深圳市龙岗区骨科医院麻醉手术科, 骨、显微外科 (广东 深圳 518029)

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摘要

目的 观察手术室皮肤管理在骨科患者术后压疮预防中的应用效果。方法 将拟于我院行骨科手术的138例患者随机 分为对照组与观察组各69例,对照组应用常规手术室护理,观察组在对照组基础上应用手术室皮肤管理护理,观察 两组护理质量、患者术后皮肤情况、压疮发生率、护理满意度情况。结果 观察组护理质量(健康宣教、体位指导、 调整受压部位、防潮处理、术中保暖、促进血液循环)评分显著高于对照组(P<0.05);观察组术后皮肤压红率显 著高于对照组(P<0.05);观察组术后7d内压疮发生率显著低于对照组(P<0.05),患者满意度显著高于对照组(P <0.05)。结论 手术室皮肤管理能够提高护理质量疾患者护理满意度,有效预防骨科手术患者术后压疮。

Objective To observe the application effects of operating room skin management on postoperative pressure sores prevention in orthopedic patients. Methods A total of 138 patients who underwent orthopedic surgery in our hospital were randomly divided into control group and observation group, with 69 cases in each group. Control group was treated with routine operating room nursing, and observation group was treated with operating room skin management nursing on the basis of control group. Nursing quality, postoperative skin conditions, incidence rate of pressure sores and nursing satisfaction were observed in the two groups. Results The scores of nursing quality (health education, position guidance, adjustment of compression site, damp-proof treatment, intraoperative warming, promotion of blood circulation) in observation group were significantly higher than those in control group (P<0.05). The skin redness rate in observation group after operation was significantly higher than that in control group (P<0.05). The incidence rate of pressure sores in observation group within 7d after operation was significantly lower than that in control group (P<0.05), and the patients’ satisfaction was significantly higher than that in control group (P<0.05). Conclusions Operating room skin management can improve the nursing quality and nursing satisfaction of patients, and effectively prevent postoperative pressure sores in patients with orthopedic surgery.

【关键词】手术室皮肤管理;骨科;术后压疮预防

【中图分类号】R68

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.03.032

前言

骨科手术患者因手术体位特殊,手术时间相对较 长,手术过程中皮肤与床褥摩擦力、剪切力等不断增 加,极易发生手术压疮[1]。调查发现,我国骨科患者 压疮并发症发生率达1.4%,严重压疮不仅影响患者术 后康复,还会使患者因疼痛、感染等原因延长住院时 间,加重护理难度[2]。大多数手术压疮均可通过认为 护理干预手段进行避免,预防压疮护理管理已成为各 类外科手术护理中的重要部分[3]。本研究在骨科手术 中应用手术室皮肤管理,发现可有效预防术后压疮, 现报道如下。