手术获得性压力性损伤风险评估量表对手术患者压力性损伤预测效果的研究

doi:10.16460/j.issn1008-9969.2021.09.066

护理学报 ›› 2021, Vol. 28 ›› Issue (9): 66-70.doi: 10.16460/j.issn1008-9969.2021.09.066

手术获得性压力性损伤风险评估量表对手术患者压力性损伤预测效果的研究

龚艳¹, 蒋琪霞^2a, 陈文芳^2b, 王海宏^3a, 马丽^3b

1.南京中医药大学护理学院,江苏南京210023;
2.中国人民解放军东部战区总医院 a.烧伤整形科; b.泌尿外科,江苏南京 210002;
3.徐州市中心医院 a.妇科; b.肿瘤外科,江苏徐州 221200

收稿日期:2021-01-13 出版日期:2021-05-10 发布日期:2021-06-09
通讯作者: 蒋琪霞（1963-）,女,江苏无锡人,硕士,主任护师,护士长。E-mail:jiangqixia1963@163.com
作者简介:龚艳（1985-）,女,江苏徐州人,本科学历,硕士研究生在读,主管护师。
基金资助:
上海王正国创伤医学发展基金会课题（WZGF20200101）

A Comparative Study of Predictive Effects of Three Assessment Scales on Surgical Acquired Pressure Injuries

GONG Yan¹, JIANG Qi-xia^2a, CHEN Wen-fang^2b, WANG Hai-hong^3a, MA Li^3b

1. School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, China;
2a. Dept. of Burn and Plastic Surgery; 2b. Dept. of Urology, General Hospital of Eastern Theater Command, Nanjing 210002, China;
3a. Dept. of Gynecology; 3b. Dept. of Surgical Oncology, Xuzhou Central Hospital, Xuzhou 221200, China

Received:2021-01-13 Online:2021-05-10 Published:2021-06-09

摘要/Abstract

摘要： 目的比较并评价手术获得性压力性损伤风险评估量表、Braden性压力性损伤风险评估量表、Munro围术期成人压力性损伤风险评估量表对外科择期手术患者手术获得性压力损伤的预测效果,为临床选择使用适宜量表提供依据。方法选取2所三级甲等医院2019年12月—2020年6月外科择期手术患者237例,应用3种量表于术前、术中、术后对患者进行压力性损伤风险评估和皮肤检查。比较3种量表的预测效果和操作便利性。结果手术获得性压力性损伤风险评估量表、Braden压力性损伤风险评估量表、Munro围术期成人压力性损伤风险评估量表,术前ROC曲线下面积AUC分别为0.695、0.619、0.684;术中ROC曲线下面积AUC分别为0.848、0.633、0.882;术后ROC曲线下面积AUC分别为0.861、0.757、0.870;3种量表的评估用时比较,手术获得性压力性损伤风险评估量表评估用时最短。结论手术获得性压力性损伤风险评估量表对手术获得性压力性损伤患者预测能力较好,方便使用,值得临床推广应用。

关键词: 手术获得性压力性损伤风险评估量表, Braden量表, Munro量表, 手术, 压力性损伤, 风险评估

Abstract: Objective To compare and evaluate the prediction effect of Intraoperatively Acquired Pressure Injury Risk Assessment Scale, Braden Pressure Injury Risk Assessment Scale and the Munro Assessment Scale for pressure injury risk in adult patients with selective operations, and to provide reference for appropriate scale of clinical practice. Methods A total of 237 patients with selective operations from December 2019 to June 2020 were selected from two tertiary, grade A hospitals and they were surveyed by using the three scales to assess the risk of pressure injury and skin examination for each patient before, during and after the surgery. The prediction effect and operation convenience of the three scales were analyzed and compared. Results For intraoperatively acquired pressure injury risk assessment scale, Braden pressure injury risk assessment scale and the Munro assessment scale for pressure injury risk, the AUC of preoperative area under the ROC curve of the three scale during perioperative period was 0.695, 0.619 and 0.684, respectively; that was 0.848, 0.633 and 0.882, respectively during the surgery and that after the operation was 0.861, 0.757 and 0.870, respectively. By comparing the assessment time of the three scales, the assessment time of intraoperatively acquired pressure injury risk assessment scale was the shortest. Conclusion The intraoperatively acquired pressure injury risk assessment scale has good predictive effect in patients with surgical acquired pressure injury. It is convenient and worthy of clinical application.

Key words: Intraoperatively Acquired Pressure Injury Risk Assessment Scale, Braden Pressure Injury Risk Assessment Scale, Munro Assessment Scale, operation, pressure injury, risk assessment

中图分类号:

R473.6

龚艳, 蒋琪霞, 陈文芳, 王海宏, 马丽. 手术获得性压力性损伤风险评估量表对手术患者压力性损伤预测效果的研究[J]. 护理学报, 2021, 28(9): 66-70.

GONG Yan, JIANG Qi-xia, CHEN Wen-fang, WANG Hai-hong, MA Li. A Comparative Study of Predictive Effects of Three Assessment Scales on Surgical Acquired Pressure Injuries[J]. Journal of Nursing, 2021, 28(9): 66-70.

参考文献

[1] 蒋琪霞,苗素琴,陈文芳,等.手术获得性压力性损伤流行特征和危险评估新进展[J].医学研究生学报,2019,32(8):882-885.DOI:10.16571/j.cnki.1008-8199.2019.08.019.
[2] Shafipour V, Ramezanpour E, Gorji MA, el at. Prevalence of Postoperative Pressure Ulcer:A Systematic Review and Meta-analysis[J].Electron Physician,2016,8(11):3170-3176.DOI:10.19082/3170.
[3] 蒋琪霞,瞿小龙,郭秀君,等.手术患者压疮发生率及发生时间和影响因素研究[J].中国护理管理,2013,13(9):25-28.DOI:10.3969/j.issn.1672-1756.2013.09.009.
[4] Kimsey DB.A Change in Focus: Shifting from Treatment to Prevention of Perioperative Pressure Injuries[J]. AORN J, 2019,110(4):379-393. DOI:10.1002/aorn.12806.
[5] 杨龙飞,宋冰,倪翠萍,等.2019版《压力性损伤的预防和治疗:临床实践指南》更新解读[J].中国护理管理,2020,20(12):1849-1854.DOI:10.3969/j.issn.1672-1756.2020.12.019.
[6] 黄灿,马玉霞,蒋梦瑶,等.压力性损伤风险评估工具的研究进展[J].上海护理,2021, 21(1):50-51.DOI:10.3969/j.issn.1009-8399.2021.01.014.
[7] 陈文芳,蒋琪霞,苗素琴,等.手术获得性压力性损伤风险评估量表的构建[J].东南国防医药,2021,23(1):81-83.DOI:10.3969/j.issn.1672-271X.2021.01.019.
[8] Chen HL,Cao YJ,Zhang W,el at. Braden scale (ALB) for Assessing Pressure Ulcer Risk in Hospital Patients: A Validity and Reliability Study[J].Appl Nurs Res, 2017,33:169-174.DOI:10.1016/j. apnr.2016.12.001.
[9] Li DX, Tang J,Gan XN.Reliability and Validity of the Munro Scale On the Assessment of Pressure Ulcer Risk in Adult Perioperative Patients:Across-sectional Study[J]. IntJClin Exp Med,2018,11(9):9811-9818.
[10] 李冬雪,盛孝敏,唐佳,等.改良版Munro围术期成人压疮风险评估量表在手术患者压疮评估中的预测性研究[J].重庆医科大学学报,2018(2):297-301.DOI:10.13406/j.cnki.cyxb.001484.
[11] 于文君,张晓红,蒋紫娟,等.Munro与Waterlow评估量表在神经外科手术患者压疮预测的效果评价[J]. 护士进修杂志,2019,34(13):1170-1174.DOI:10.16821/j.cnki.hsjx.2019.13.005.
[12] Mrdjenovich D,Simman R,Fleck C,et al.The American College of Clinical Wound Specialists Rebuttal to the Recent NPUAP Pressure Ulcer Definition[J].JAm Coll Clin Wound Spec,2016,7(1-3):53.DOI:10.1016/j.jccw.08.002.
[13] 喻海涛,孙琳,韩小琴,等.3种创伤严重程度评分方法对老年创伤患者院内死亡预测价值的比较研究[J].护理学报,2020,27(8):34-37.DOI:10.16460/j.issn1008-9969.2020.08.034.
[14] 倪洁,葛兆霞.衰弱前期老年患者运动衰弱干预试验效果观察[J].护理学报,2019,26(15):65-69.DOI:10.164660/j.issn1008-9969.2019.15.065.
[15] 龚艳,蒋琪霞.手术获得性压力性损伤危险因素及预防策略的研究进展[J].中华现代护理杂志,2020,26(25):3409-3413.DOI:10.3760/cma.j.cn115682-20200218-00798.
[16] 洪佳莹,吴彦,赵洁.汉化版Munro成人手术室压疮风险评估表在全身麻醉手术中的应用研究[J].中国医药科学,2019,9(5):153-155.DOI:10.3969/j.issn.2095-0616.2019.05.045.
[17] 颜虹,徐勇勇.医学统计学[M].3版.北京:人民卫生出版社,2018:220-236.
[18] Park SH, Choi YK, Kang CB.Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Hospitalized Patients[J].JTissue Viability, 2015,24(3):102-113. DOI:10.1016/j.jtv.2015.05.001.
[19] 蒋琪霞. 压疮护理学[M].北京:人民卫生出版社,2015:102-105.
[20] 张安美,李照坤,郑宏伟.改良压疮评估量表用于骨科手术病人压力性损伤评估的可行性分析[J].潍坊医学院学报,2020,42(5):391-393.DOI:10.16846/j.issn.1004-3101.2020.05.022.

Metrics

Viewed

Full text

Abstract

Cited

Shared

手术获得性压力性损伤风险评估量表对手术患者压力性损伤预测效果的研究

A Comparative Study of Predictive Effects of Three Assessment Scales on Surgical Acquired Pressure Injuries

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 10

[1]	陈晓霞, 刘小民, 宋海娟, 张新芳, 谢庆. 7例胎儿行宫内肺动脉瓣成形术的术中护理[J]. 护理学报, 2021, 28(9): 71-73.
[2]	胡正中, 廖园园, 周毅峰, 彭瑨, 秦月兰. 结直肠癌患者手术切口感染危险因素的Meta分析[J]. 护理学报, 2021, 28(8): 23-27.
[3]	管艳, 卢山, 叶家欣, 王哲芸. 心脏术后压力性损伤规范化实践方案的构建与应用[J]. 护理学报, 2021, 28(7): 15-20.
[4]	高兴莲, 余文静, 肖瑶, 胡娟娟, 赵诗雨, 杨英. 手术患者围术期压力性损伤预防及管理最佳证据总结[J]. 护理学报, 2021, 28(6): 22-26.
[5]	叶衍涓, 姚瑶, 唐艳平, 杨肖娜. 缩短全麻择期手术患者术前禁食禁饮时间的品管圈实践[J]. 护理学报, 2021, 28(4): 9-11.
[6]	徐昌霞, 朱新宇, 孙志岭, 陈斌, 杨婷. 危害分析关键控制点体系在手术标本管理中的实证研究[J]. 护理学报, 2021, 28(3): 1-5.
[7]	秦鸿利, 赵震, 王艳芳, 卢颖, 王志霞, 李黎明. ICU患者压力性损伤预防的最佳证据总结[J]. 护理学报, 2021, 28(10): 45-51.
[8]	张永苹, 宋亚敏, 凌云, 李天宝, 魏广东. 64例全胸腔镜不停跳下行心脏三尖瓣膜手术后患者的护理[J]. 护理学报, 2021, 28(10): 70-71.
[9]	王辉, 丁鹏勋, 任天尧, 王珏, 王英丽, 张圣洁. 1例达芬奇机器人辅助胰体尾脾切除联合左肾部分切除的护理[J]. 护理学报, 2021, 28(10): 75-76.
[10]	李文姬, 龚凤球, 周厚君, 耿熹洁, 杨云. 多功能手术体位车的研制与应用[J]. 护理学报, 2021, 28(1): 76-78.
[11]	刘丽欢, 刘春香. 经皮肾镜取石术日间手术患者的规范化流程管理[J]. 护理学报, 2020, 27(9): 14-18.
[12]	张沁青, 谭耘. 降低日间手术当日取消率的品管圈实践[J]. 护理学报, 2020, 27(9): 19-22.
[13]	刘颖, 黎丹, 黄燕波, 王倩, 贯华. 优化术前肠道准备方案对根治性膀胱全切加回肠通道术患者的影响[J]. 护理学报, 2020, 27(9): 68-70.
[14]	吴磊, 周济宏, 蒋琪霞. 2例4期压力性损伤继发鳞状细胞癌患者护理难点与临床特征分析及干预[J]. 护理学报, 2020, 27(6): 65-68.
[15]	周燕茹, 王丽娜, 葛晨希, 王凤, 赵霞. 多功能翻身枕的设计及其在Ⅰ期压力性损伤患者中的应用[J]. 护理学报, 2020, 27(6): 74-77.