摘要
目的分析高危孕产妇剖宫产术中获得性压力性损伤的高危因素。方法采用回顾性分析法,选取2019年8月至2022年8月在首都医科大学附属北京妇产医院行剖宫产手术的高危孕产妇520例。根据是否发生获得性压力性损伤将其分为发生获得性压力性损伤组(20例)和未发生获得性压力性损伤组(500例)。收集高危孕产妇年龄、体质指数、手术时长、合并产科高危因素(贫血、子宫肌瘤、低蛋白血症、糖尿病、胎膜早破、产后出血)、自然分娩中转剖宫产、局部潮湿、术中低体温、麻醉方式、有无卧床史,调查术后发生获得性压力性损伤的现状,分析发生获得性压力性损伤的高危因素。结果520例具有产科高危因素的孕产妇行剖宫产手术后20例发生了不同程度的获得性压力性损伤。单因素分析显示局部潮湿、合并贫血、合并子宫肌瘤、合并低蛋白血症、合并糖尿病、产后出血、术中低体温、麻醉方式是高危孕产妇行剖宫产手术发生获得性压力性损伤的高危因素(P<0.05)。多因素Logistic回顾分析显示,局部潮湿、合并贫血、合并低蛋白血症、合并糖尿病、产后出血、术中低体温是高危孕产妇行剖宫产手术发生获得性压力性损伤的高危因素(P<0.05)。结论合并有产科高危因素的孕产妇术中获得性压力性损伤的发生涉及自身和微环境多种危险因素,护理人员应关注术中获得性压力性损伤的高危因素,做好术前评估,给予好发部位皮肤有效的保护和预防措施,以减少术中获得性压力性损伤的发生。
Objective To analyse risk factors for high-risk pregnant women for pressure injury acquired during caesarean section.Methods Using retrospective analysis,520 high-risk pregnant women who underwent cesarean section in our hospital from August 2019 to August 2022 were selected.According to whether pressure injury occurred,it was divided into pressure injury group(n=20)and no pressure injury group(n=500).The age of high-risk pregnant women,BMI,length of surgery,obstetric risk factors(anemia,uterine fibroids,hypoproteinemia,diabetes,premature rupture of membranes,postpartum hemorrhage),spontaneous delivery and transfer of caesarean section,local humidity,intraoperative hypothermia,anesthesia method,and history of bed rest were collected,the current status of postoperative pressure injury was investigated,and the risk factors for pressure injury were analyzed.Results After cesarean section surgery,20 of the 520 women with obstetric risk factors underwent caesarean section and developed pressure injuries of varying degrees.Univariate analysis showed that local dampness,anemia,uterine fibroids,hypoproteinemia,diabetes,postpartum haemorrhage,intraoperative hypothermia,and anesthesia were high-risk factors for pressure injury during cesarean section in high-risk pregnant women(P<0.05).Logistic retrospective analysis showed that local dampness,anemia,hypoproteinemia,diabetes,postpartum hemorrhage,and intraoperative hypothermia were high-risk factors for pressure injury in high-risk pregnant women undergoing cesarean section(P<0.05).Conclusions The occurrence of intraoperative stress injury in pregnant women with obstetric risk factors involves multiple risk factors for themselves and the microenvironment,Nursing staff should pay attention to the high-risk factors of skin pressure injury,do a good job of preoperative assessment,and give effective protection and preventive measures to the skin in the good area to reduce the occurrence of skin pressure injury during surgery.
作者
孙晶
闫秋菊
姜梅
王炎烔
王云飞
Sun Jing;Yan Qiuju;Jiang Mei;Wang Yantong;Wang Yunfei(Department of Operating Room,Beijing Obsterics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)
出处
《中国医学前沿杂志（电子版）》
CSCD
2023年第6期47-51,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
首都医科大学附属北京妇产医院北京妇幼保健院“管理专项”课题(FCYYGL201910)。
关键词
高危孕产妇
术中获得性压力性损伤
高危因素
High-risk pregnant women
Intraoperative pressure injury
High-risk factors
