[1]缪爱梅,何小兰,倪亚利,等.基于微环境理论的延续性护理对截瘫患者皮瓣修复术后再发压力性损伤的影响[J].军事护理,2022,39(06):35-38.[doi:10.3969/j.issn.1008-9993.2022.06.009]
　MIAO Aimei,HE Xiaolan,NI Yali,et al.Effect of Continuity of Care Based on Microclimate Theory on the Recurrence of Pressure Injury in Patients with Paraplegia After Skin Flap Repair Operation[J].Nursing Journal Of Chinese People's Laberation Army,2022,39(06):35-38.[doi:10.3969/j.issn.1008-9993.2022.06.009]
点击复制

基于微环境理论的延续性护理对截瘫患者皮瓣修复术后再发压力性损伤的影响
分享到：

《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
39
期数:
2022年06期
页码:
35-38
栏目:
论著
出版日期:
2022-06-15

文章信息/Info

Title:
Effect of Continuity of Care Based on Microclimate Theory on the Recurrence of Pressure Injury in Patients with Paraplegia After Skin Flap Repair Operation
文章编号:
1008-9993(2022)06-0035-04
作者:
缪爱梅; 何小兰; 倪亚利; 林才; 周慧芬; 衡晓莎; 黄好好
(温州医科大学附属第一医院 烧伤/伤口中心,浙江 温州 325000)
Author(s):
MIAO Aimei; HE Xiaolan; NI Yali; LIN Cai; ZHOU Huifen; Heng Xiaosha; Huang Haohao
(Department of Burn/Wound Center,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China)
关键词:
延续性护理;  截瘫;  微环境;  压力性损伤;  再发
Keywords:
continuity of care;  paraplegia;  microclimate;  pressure injury;  recurrence
分类号:
R473.3
DOI:
10.3969/j.issn.1008-9993.2022.06.009
文献标志码:
A
摘要:
目的 探讨基于微环境理论的延续性护理对截瘫患者皮瓣修复术后再发压力性损伤(pressure injury,PI)的影响,以期为提高延续性护理质量提供依据。方法 2016年1月至2020年3月,便利抽样法选取截瘫伴PI患者132例为研究对象,按随机数字表法将其分为观察组和对照组,对照组给予常规术后护理和随访,观察组在对照组的基础上给予基于微环境理论的延续性护理,主要包括居室和皮肤局部的温湿度调控。两组患者均进行前瞻性随访记录PI首次再发情况,随访间隙3个月。结果 对照组有9例再发PI,无PI生存时间M(P0～P100)为7(1～29)个月; 观察组有3例再发PI,无PI生存时间M(P0～P100)为32(13～36)个月。两组无PI复发生存曲线差异有统计学意义(χ2=3.958,P=0.047)。结论 在微环境理论指导下的延续性护理能减少深度PI截瘫患者皮瓣修复术后PI的再发,值得推广。
Abstract:
Objective To explore the effect of continuity of care based on microclimate theory on the recurrence of pressure injury(PI)in patients with paraplegia after skin flap repair operation,and to provide basis for the improvement of nursing quality.Methods From January 2016 to March 2020,132 patients with paraplegia PI were selected as the research objects by the convenience sampling method,and were divided into the observation group and the control group according to random number table method.The control group was given routine nursing and postoperative follow-up,while the observation group were given additional continuity of care based on the theory of the microclimate mainly including the bedroom and local skin temperature and humidity control.Patients in both groups were prospectively followed up to record the first recurrence of PI every 3 months.Results 9 cases in the control group showed recurrence of PI with the PI-free survival time of 7(1-29)months; 3 cases in the observation group showed recurrence of PI with the PI-free survival time of 32(13-36)months.There was a statistically significant difference in PI-free survival curves between the 2 groups(χ2=3.958,P=0.047).Conclusions Continuity of care based on microclimate theory can reduce PI recurrence after skin flap repair operation in paraplegia patients with deep PI,which was worthy of further promotion.

参考文献/References:

[1] 贾晓明.压疮的流行病学特点及诊断与治疗进展[J].中华损伤与修复杂志:电子版,2018,13(1):4-7.
[2] 蒋鹏,杨力,潘圣鑫,等.负压封闭引流联合臀大肌V-Y肌皮瓣转移修复臀部软组织缺损[J].中国美容医学,2018,27(2):44-46.
[3] 郭巧英,杨琼,赵煜,等.24例肌皮瓣转移修复截瘫后臀部Ⅳ期压疮患者的护理[J].护理学报,2015,22(2):36-37.
[4] National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel.Prevention and treatment of pressure ulcers:clinical practice guideline[S].Washington DC:National Pressure Ulcer Advisory Panel,2009.
[5] ROSIN N R,TABIBI R S,TRIMBATH J D,et al.A primary care provider's guide to prevention and management of pressure injury and skin breakdown in people with spinal cord injury[J].Top Spinal Cord Inj Rehabil,2020,26(3):177-185.
[6] 马珂珂,丁四清,钟竹青,等.冠状动脉硬化性心脏病患者延续性护理现状及对策[J].,2018, 35(3):25-30.
[7] 张诗怡,赵体玉,乐霄,等.微环境与压力性损伤关系的研究进展[J].中华护理杂志,2017,52(8):1001-1006.
[8] 张诗怡,赵体玉,乐霄,等.术中压力性损伤与受压部位微环境关系的研究[J].护理学杂志,2021,36(4):40-42,61.
[9] 曹燕,钱丹,蔡亚萍,等.医用降温贴对重症监护室病人压疮的预防作用[J].护理研究:下旬版,2015,29(9):1120-1121.
[10]CHEN H L,ZHU B,WEI R,et al.A retrospective analysis to evaluate seasonal pressure injury incidence differences among hip fracture patients in a tertiary hospital in East China[J].Ostomy Wound Manage,2018,64(2):40-44.
[11]王敏丹,王宏.降温贴在预防腹腔镜直肠癌根治术骶尾部压力性损伤中的应用研究[J].实用临床护理学电子杂志,2020,5(47):139,157.
[12]AMRANI G,PEKO L,HOFFER O,et al.The microclimate under dressings applied to intact weight-bearing skin:infrared thermography studies[J/OL].https://linkinghub.elsevier.com/retrieve/pii/S0268-0033(20)30103-0.DOI:10.1016/j.clinbiomech.2020.104994.
[13]WU K S,VAN OSDOL W W,DAUSKARDT R H.Mechanical properties of human stratum corneum:effects of temperature,hydration,and chemical treatment[J].Biomaterials,2006,27(5):785-795.
[14]IAIZZO P A,KVEEN G L,KOKATE J Y,et al.Prevention of pressure ulcers by focal cooling:histological assessment in a porcine model[J].Wounds,1995,7(5):161-169.
[15]BATES-JENSEN B M,MCCREATH H E,KONO A,et al.Subepidermal moisture predicts erythema and stage 1 pressure ulcers in nursing home residents:a pilot study[J].J Am Geriatr Soc,2007,55(8):1199-1205.
[16]BRIENZA D M,GEYER M J.Using support surfaces to manage tissue integrity[J].Adv Skin Wound Care,2005,18(3):151-157.
[17]戴付敏,王丽君,CHRISTINE B,等.国外老年人皮肤干燥评估与干预的研究进展[J].中华护理杂志,2017,52(1):53-58.
[18]王晓丽,王运平,邹雯妃,等.基于微信公众平台的延续性护理在压疮高危患者中的应用效果评价[J].中国实用护理杂志,2017,33(12):937-941.

备注/Memo

备注/Memo:
【 收稿日期 】 2021-06-09 【 修回日期 】 2022-03-08
【 基金项目 】 温州市2017年公益性科技计划项目(Y20170114)
【 作者简介 】 缪爱梅,本科,主管护师,从事压力性损伤、烧伤危重患者的护理与管理
【 通信作者 】 林才,电话:0577-55579432
更新日期/Last Update: 2022-06-15