临床常用营养指标对ICU患者压疮发生预警作用.docVIP

临床常用营养指标对ICU患者压疮发生的预警作用 　　[摘要]目的 探?临床常用营养指标与ICU患者压疮发生的关系。方法 采用自行设计的ICU患者压疮危险因素调查表对2016年5月～2017年2月在广东省某三级甲等医院ICU住院的256例患者进行调查分析。结果 单因素分析显示，压疮组与非压疮组在血红蛋白、红细胞、血细胞比容、白蛋白、总蛋白、上臂围、小腿围、体质量指数等方面的比较差异有统计学意义（P0.05）；Logistic回归分析显示，白蛋白水平降低和小腿围减小是ICU患者压疮发生的独立危险因素。结论 医护人员应重视白蛋白水平降低和小腿围减小对压疮的预警作用。 　　[关键词]ICU；压疮；营养指标；危险因素 　　[中图分类号] R473 [文献标识码] A [文章编号] 1674-4721（2017）05（b）-0138-03 　　Early warning effect of clinical nutrition index on pressure ulcer in patients with ICU 　　HUO Wan-jun1 LIU Rong-min1 XIONG Xiao-ling2 　　1.School of Nursing，Guangdong Pharmaceutical University in Guangdong Province，Guangzhou 510000， China；2.Department of Intensive Care Unit，the First Affiliated Hospital of Guangdong Pharmaceutical University，Guangdong Province，Guangzhou 510000，China 　　[Abstract]Objective To explore the relationship between pressure ulcers and common clinical nutritional indexes in ICU patients.Methods 256 hospitalized patients in ICU of a three class A hospital in Guangdong Province from May 2016 to February 2017 were investigated by using self-designed questionnaire for risk factors of decubitus ulcers in ICU patients.Results Univariate analysis showed that there were significant differences in hemoglobin，red blood cell，hematocrit，albumin，total protein，mid-upper arm circumference，calf circumference and body mass index between two groups （P0.05）.Logistic regression analysis showed that，the decrease of albumin level and calf circumference were independent risk factors for pressure ulcer in ICU patients.Conclusion The medical staff should pay attention to the early warning effect of the decrease of albumin level and calf circumference on pressure ulcers. 　　[Key words]Intensive care unit；Pressure ulcer；Nutritional index；Risk factors 　　压疮指位于骨隆突处、医疗或其它器械下的皮肤和/或软组织的局部损伤[1]。目前临床上压疮的患病率和发生率仍然很高，尤其是重症监护（intensive care unit，ICU）患者。研究发现，ICU内压疮的患病率为14%～41%，发生率为1%～56%，是普通病房的2～3倍[2]。有文献[3-4]报道，营养情况与ICU患者压疮的发生有关。目前国内外常用压疮评估量表存在缺少营养评估条目，或营养评估条目仅根据营养方式和进食量进行评估等问题，不能起到有效预测ICU患者压疮发生的作用，因此需要结合客观的