某醫學中心手術臥位與手術壓瘡嚴重度之分析

Analysis of the Sevevity of Intraoperative Position- Related Pressure Sore in a Medical Center

林麗華(Li-Hua Lin) ； 莊馥蓮(Fu-Lien Chuang) ； 劉秋玉(Chiu-Yu Liu) ； 吳幸芬(Shing-Fen Wu) ； 唐苡甄(Yi-Chen Tang)

《榮總護理》 33卷1期 (2016/03) Pp. 13-20

https://doi.org/10.6142/VGHN.33.1.13

摘要

本回溯性研究旨在分析南部某醫學中心手術病人的臥位與手術壓瘡發生率、面積、級數之差異。樣本資料取自該醫學中心2014年1月至12月「手術室、恢復室病人流程管理系統」與google雲端壓瘡紀錄表，結果發現19,302位病人(25,649人次)有568位(1126人次)於手術期間產生壓瘡，壓瘡發生率為4.4%，以男性(p=63.6%)且全身麻醉(p=99.1%)較多；級數以第一級壓瘡為多(p=83.5%)，其次是第二級壓瘡(p=15.8 %)；壓瘡發生率以手術姿勢俯臥最多(p=16.6%)，二級以上壓瘡以側臥發生率最高(p=34.1%)；在壓瘡面積上，仰臥和側臥者大於俯臥者；期望本研究結果能增進手術室醫護人員對手術壓瘡的認識，進而提出有效預防與改善措施，以提升手術全期照護品質；研究數據可做為醫療院所設定手術壓瘡品管閾值，手術室實證研究方向之參考。

關鍵字

手術壓瘡 ； 手術臥位

並列摘要

This study investigated and compared the development rates, areas, and grades of pressure sores in surgical patients in four operative positions at a medical center. This retrospective cohort study was designed using data from January to December 2014 which were extracted from the operation and postoperative recovery room management systems, and the records on pressure sores were uploaded onto Google Cloud. During the study period, 25,649 surgeries were conducted on 19,302 patients in the medical center. Of these, pressure sores developed after 1,126 surgeries in 568 patients; these patients were analyzed further. The rate of pressure sore development was 4.4%, with the majority being first grade sores (83.5%), followed by second grade sores (15.8%). Furthermore, compared with female patients, more male patients had pressure sores (63.6%). In addition, most surgeries under general anesthesia (99.1%) resulted in pressure sore development. Four types of surgery supine to prone highest incidence of pressure ulcers (16.6%). The degree of pressure ulcers at a ratio of more than two highest occurrence of side (34.1%). The supine and lateral positions caused significantly more pressure sore development than did the prone position. The current study results can serve as a reference for developing nursing management for perioperative pressure sore development and also aid in improving patient care quality by providing further evidence-based research results.

並列關鍵字

pressure sore ； operative positioning

參考文獻

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