护理学报 ›› 2019, Vol. 26 ›› Issue (3): 20-23.doi: 10.16460/j.issn1008-9969.2019.03.020
冯尘尘1, 王蒙蒙2, 唐秀美2, 周煜2, 赵淑珍1
摘要: 目的 综述国内外最新的早期压力性损伤识别方法,为临床提供参考,提出未来研究方向。方法 查阅并整理国内外有关早期压力性损伤识别方法的文献,根据文献结果进行总结。结果 结合压力性损伤发生机制,主要介绍了高频超声、热成像技术、皮下湿度监测、近红外光谱4种已应用于国内外临床的早期识别方法的原理与应用现状,同时介绍了报道较少的磁共振弹性成像与超声弹性成像技术。结论 可将以上技术应用于我国患者,比较其与传统评估方式在预测性、经济性、可操作性上的优劣。此外,未来研究需针对特定特点的患者,形成不同检测技术的结果评价标准,以更好地指导临床护理。对尚未在临床展开应用的技术,应积极开展多学科合作,产生新的专利或产品,实现研究的转化与应用。
中图分类号:
[1] Edsberg L E, Black J M, Goldberg M, et al.Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System[J]. J Wound Ostomy Continence Nurs, 2016,43(6):585-597.DOI:10.1097/WON.0000000000000281. [2] 胡婉平,李银英,杨春梅,等. 综合护理干预对早期压力性损伤预防的作用[J].中国伤残医学, 2018,26(13):98-99. DOI:10.13214/j.cnki.cjotadm.2018.13.064. [3] Kim C, Park S, Ko J W, et al.The Relationship Of Subepidermal Moisture and Early Stage Pressure Injury by Visual Skin Assessment[J]. J Tissue Viability, 2018,27(3):130-134. DOI:10.1016/j.jtv.2018.05.002. [4] Schuurman J, Schoonhoven L, Defloor T, et al. Economic Evaluation of Pressure Ulcer Care: A Cost Minimization Analysis of Preventive Strategies[J]. Nurs Econ, 2009, 27(6):390-400, 415.PMID:20050490. [5] 张玲玲. 某三级教学医院住院患者压疮现患率研究[D]. 济南: 山东大学, 2017. [6] Jan Y K, Brienza D M. Technology for Pressure Ulcer Prevention[J]. Top Spinal Cord Inj Rehabil, 2006, 11(4):30-41. https://doi.org/10.1310/26R8-UNHJ-DXJ5-XG7W. [7] Papanikolaou P, Lyne P, Anthony D.Risk Assessment Scales for Pressure Ulcers: A Methodological Review[J]. Int J Nurs Stud, 2007,44(2):285-296. DOI:10.1016/j.ijnurstu.2006.01.015. [8] Anthony D, Parboteeah S, Saleh M, et al.Norton, Waterlow and Braden Scores: A Review of the Literature and a Comparison Between the Scores and Clinical Judgement[J]. J Clin Nurs, 2008, 17(5):646-653.DOI:10.1111/j.1365-2702.2007.02029.x. [9] 宁翠霞,毕越英. 压疮的基础实验研究进展[J]. 现代中西医结合杂志,2017,26(27):3075-3078.DOI:10.3969/j.issn.1008-8849.2017.27.040. [10] 李小寒,尚少梅.基础护理学[M].北京:人民卫生出版社,2017:167. [11] 王艳艳,姜丽萍,张恩,等.压疮发生的生物力学和循环代谢机制研究进展[J].护理学杂志(外科版),2010,25(8):93-96. DOI:10.3870/hlxzz.2010.08.093. [12] Yusuf S, Okuwa M, Shigeta Y, et al.Microclimate And Development of Pressure Ulcers and Superficial Skin Changes [J]. Int Wound J,2015,12(1):40-46. DOI:10.1111/iwj.12048. [13] 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. DOI:10.3761/j.issn.0254-1769.2017.08.021. [14] 蒋金龙,何桥,冯慧. 小儿术中体温升高与压力性损伤的关系探讨及护理[J]. 护士进修杂志, 2017, 32(19):1806-1808. DOI:10.16821/j.cnki.hsjx.2017.19.025. [15] Andersen E S, Karlsmark T.Evaluation of Four Non-invasive Methods for Examination and Characterization of Pressure Ulcers[J]. Skin Res Technol, 2008, 14(3):270-276. DOI:10.1111/j.1600-0846.2008.00290.x. [16] Kuhn C, Angehrn F.Use of High-resolution Ultrasound to Monitor the Healing of Leg Ulcers: A Prospective Single-Center Study[J]. Skin Res Technol, 2009, 15(2):161-167. DOI:10.1111/j.1600-0846.2008.00342.x. [17] Jasaitiene D, Valiukeviciene S, Linkeviciute G, et al.Principles of High-frequency Ultrasonography for Investigation of Skin Pathology[J]. J Eur Acad Dermatol Venereol, 2011,25(4):375-382. DOI:10.1111/j.1468-3083.2010.03837.x. [18] Porter-Armstrong A P, Adams C, Moorhead A S, et al. Do High Frequency Ultrasound Images Support Clinical Skin Assessment?[J]. ISRN Nursing, 2013,2013:1-5. DOI:10.1155/2013/314248. [19] Lucas V S, Burk R S, Creehan S, et al.Utility of High-frequency Ultrasound: Moving Beyond the Surface to Detect Changes In Skin Integrity[J]. Plast Surg Nurs, 2014, 34(1): 34-38. DOI:10.1097/PSN.0000000000000031. [20] Burk R S, Schubert C M, Pepperl A, et al.High-frequency Ultrasound[J]. J Wound Ostomy Continence Nurs, 2017,44(5):434-439. DOI:10.1097/WON.0000000000000354. [21] Grap M J, Burk R S, Lucas V, et al.Use of High Frequency Ultrasound to Detect Changes in Skin Integrity: An Image Evaluation Validation Procedure[J]. Intensive Crit Care Nurs,2015, 31(3):141-147. DOI:10.1016/j.iccn.2014.08.002. [22] Calado C R, Calado F A R, Caput G, et al. Porosity and Delamination Defect Detection in Ceramic Materials by Active Infrared Thermography and Optical Digital Microscopy[J]. Materials Science Forum,2014,798/799:671-676. DOI:10.4028/www.scientific.net/MSF.798-799.671. [23] Schlager O, Gschwandtner M E, Herberg K, et al.Correlation of Infrared Thermography and Skin Perfusion in Raynaud Patients and in Healthy Controls[J]. Microvasc Res, 2010, 80(1):54-57. DOI:10.1016/j.mvr.2010.01.010. [24] Farid K J, Winkelman C, Rizkala A, et al.Using Temperature of Pressure-related Intact Discolored Areas of Skin to Detect Deep Tissue Injury: An Observational, Retrospective, Correlational Study[J]. Ostomy Wound Manage, 2012,58(8):20-31. [25] Judy D D, Brooks B B, Fennie K P M, et al. Improving the Detection of Pressure Ulcers Using the TMI ImageMed System[J]. Adv Skin Wound Care, 2011,24(1):18-24. DOI: 10.1097/01.ASW.0000392925.83594.50. [26] Sanchis-Sánchez E, Sanchis-Sánchez C, Sánchez-Lorente M M, et al. Use of Thermography in the Diagnosis of Pressure Ulcers Category I: A Protocol Proposal:2016 Global Medical Engineering Physics Exchanges/Pan American Health Care Exchanges (Gmepe / Pahce), 2016[C]. [27] Yamamoto T, Yamamoto N, Azuma S, et al.Handy Thermography For Bedside Evaluation Of Pressure Ulcer[J]. J Plast Reconstr Aesthet Surg, 2013,66(7):e205-e206. DOI: 10.1016/j.bjps.2013.02.005. [28] Moore Z, Patton D, Rhodes S, et al.Subepidermal Moisture (SEM) and Bioimpedance: A Literature Review of a Novel Method for Early Detection of Pressure-induced Tissue Damage (Pressure Ulcers)[J]. Int Wound J,2017,14(2):331-337. DOI:10.1111/iwj.12604. [29] Clendenin M, Jaradeh K, Shamirian A, et al.Inter-operator and Inter-device Agreement and Reliability of the SEM Scanner[J]. J Tissue Viability, 2015,24(1):17-23. DOI:10.1016/j.jtv.2015.01.003. [30] Bates-Jensen B M, McCreath H E, Kono A, et al. Subepidermal Moisture Predicts Erythema And Stage Ⅰ Pressure Ulcers In Nursing Home Residents: A Pilot Study[J]. J Am Geriatr Soc,2007, 55(8):1199-2205. DOI:10.1111/j.1532-5415.2007.01261.x. [31] Bates-Jensen B M, McCreath H E, Pongquan V, et al. Subepidermal Moisture Differentiates Erythema and Stage Ⅰ Pressure Ulcers in Nursing Home Residents[J]. Wound Repair Regen ,2008, 16(3):189-197.DOI:10.1111/j.1524-475X.2008.00359.x. [32] 李增勇,王岩,辛青,等. 压疮易患组织的血氧参量近红外光谱法监测及压力影响分析[J].光谱学与光谱分析, 2011, 31(6):1490-1493.DOI:10.3964/j.issn.1000-0593(2011)06-1490-04. [33] 张龙,陈丽莉,孙熠. ICU患者压疮易患部位组织血氧变化的近红外光谱法监测分析[J]. 护理学杂志, 2012,27(24):4-7. DOI:10.3870/hlxzz.2012.24.004. [34] 王岩. 基于近红外光谱法的人体组织压力影响分析及压疮风险评估建模[D]. 济南:山东大学, 2011. [35] 张龙. 应用近经外光谱对ICU患者压疮易患部位的血氧参数检测及影响因素分析[D].温州:温州医学院, 2013. [36] 姜丽萍,张龙,陈丽莉,等. 应用Braden量表联合近红外光谱仪评估ICU患者压疮发生的研究[J]. 中华护理杂志, 2014, 49(8):901-904. DOI:10.3761/j.issn.0254-1769.2014.08.001. [37] Schäfer G, Dobos G, Lünnemann L, et al.Using Ultrasound Elastography to Monitor Human Soft Tissue Behaviour During Prolonged Loading: A Clinical Explorative Study[J]. J Tissue Viability, 2015,24(4):165-172. DOI:10.1016/j.jtv.2015.06.001. [38] Muthupillai R, Ehman R L.Magnetic resonance elastography[J]. Nat Med,1996:2(5):601-603. [39] Ophir J.Elastography a Quantitative Method for Imaging the Elasticity of Biological Tissues[J]. Ultrason Imaging,1991,13(2):111-134. DOI:10.1177/016173469101300201. [40] Nelissen J L, de Graaf L, Traa W A, et al. A MRI-compatible Combined Mechanical Loading and MR Elastography Setup to Study Deformation-induced Skeletal Muscle Damage in Rats[J]. PLOS ONE, 2017,12(1):e169864. DOI:10.1371/journal.pone.0169864. |
[1] | 李嫒, 庞艳, 林芳初, 涂素华. 婴幼儿顺应喂养的研究进展[J]. 护理学报, 2020, 27(7): 34-37. |
[2] | 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. |
[3] | 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. |
[4] | 方金林, 叶红芳, 沈孟菲, 赵晓婷. 护士对员工援助计划的应用需求现状[J]. 护理学报, 2020, 27(4): 21-24. |
[5] | 汤琳, 孟爱凤, 智晓旭, 邾萍, 浦亚楼, 路莉静. 癌症青年患者社会心理干预的研究进展[J]. 护理学报, 2020, 27(12): 10-13. |
[6] | 王亚婷, 彭晓红, 董正惠. ICU心脏外科术后成人患者压力性损伤影响因素分析[J]. 护理学报, 2019, 26(3): 1-4. |
[7] | 邓爱萍, 吴妹清, 袁平乔, 杨玲. 帕金森病患者睡眠障碍研究进展[J]. 护理学报, 2019, 26(18): 27-31. |
[8] | 田丽, 李梦媛, 李佳倩, 朱冰洁, 张青月, 阎玲. COPD患者预立医疗照护计划的研究进展[J]. 护理学报, 2019, 26(17): 22-26. |
[9] | 姚丽娟, 李红梅, 钱卫琴, 白佳燕, 达玉娟. 新型手术侧卧位固定垫的设计与临床应用[J]. 护理学报, 2019, 26(17): 77-78. |
[10] | 尹玲, 胡燕华, 郑凤华, 冉栩. 儿童日间手术焦虑情绪管理研究现状[J]. 护理学报, 2019, 26(15): 27-30. |
[11] | 姚秀英, 耿丽, 张理想, 黄蕾, 陈霞, 安曼德. ICU患者压力性损伤预测风险列线图模型的建立[J]. 护理学报, 2019, 26(11): 55-59. |
[12] | 孙骏玉,束娇娇,帕丽达·买买提. 国内外护生职业认同研究现状与思考[J]. 护理学报, 2018, 25(9): 31-34. |
[13] | 罗桥芳,张艳红,黄健敏,刘绍燕,叶月桂. 静态床垫结合翻身预防老年卧床患者压力性损伤的效果观察[J]. 护理学报, 2018, 25(7): 56-59. |
[14] | 郭一峰, 陈亚萍, 王晓杰, 徐园, 马玉芬. 国外急性深静脉血栓患者应用弹力袜治疗的研究进展[J]. 护理学报, 2018, 25(21): 24-28. |
[15] | 黎喆, 丁欣. 衰弱评估在主动脉瓣狭窄患者中的应用进展[J]. 护理学报, 2018, 25(20): 14-17. |
|