摘要
目的:探讨重症监护室(ICU)病人压力性损伤(PI)发生的危险因素,并分析胸骶经皮氧分压变异率(TcPO_(2)CV)、前白蛋白单独及联合检测对ICU病人压力性损伤发生的预测价值。方法:选取2021年1月至2022年06月入住苏州大学附属苏州九院ICU治疗的重症病人227例,对其人口学资料、病情相关监测指标、压力性损伤因素进行回顾性分析,采用多因素Logistic回归法分析压力性损伤发生的独立影响因素,并绘制受试者工作特征(ROC)曲线验证胸骶经皮氧分压变异率、前白蛋白单独及联合检测对重症病人压力性损伤发生风险的预测作用。结果:227例ICU病人中,共33例发生压力性损伤,发生率为14.54%;单因素分析显示压力性损伤组病人的年龄、APACHEⅡ评分、TcPO_(2)CV高于非压力性损伤组,而BMI、前胸壁Tc PO2、骶尾部TcPO_(2)、前白蛋白低于非压力性损伤组,差异均具有统计学意义(P<0.01)。多因素Logistic回归分析显示,TcPO_(2)CV(OR=1.234,95%CI:1.138~1.337)、前白蛋白(OR=0.969,95%CI:0.956~0.983)分别为重症病人发生PI的独立危险因素和独立保护因素(P<0.01)。TcPO_(2)CV、前白蛋白监测压力性损伤的最佳截断值分别为21.63%和116.1 mg/L,ROC曲线下面积(AUC)为0.878、0.869。结论:胸骶经皮氧分压变异率、前白蛋白对重症病人PI风险预测具有一定价值,可作为一种新的客观评估方法指导临床早期识别重症病人PI的发生。
Objective:To investigate the risk factors of pressure injury(PI)in ICU patients,and to analyze the power of percutaneous thoracacral oxygen partial pressure variation rate(TcPO_(2)CV),prealbumin alone and in combination for prediction of pressure injury in ICU patients.Methods:227 cases of ICU patients in Suzhou Ninth Hospital affiliated to Soochow University from January 2021 to June 2022 were included,and their demographic data,Disease-related monitoring indicators and occurrence of pressure injury were retrospectively analyzed.Multivariate logistic regression was conducted to analyze the risk factors of pressure injury.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of the TcPO_(2)CV,prealbumin alone and in combination for the risk of pressure injury.Results:Among 227 ICU patients,33 cases(14.54%)had pressure injury.Univariate analysis showed that age,APACHE II score and TcPO_(2)CV in the pressure injury group were higher than those in the non-pressure-injury group,while BMI,TCPO2 of anterior chest wall,TCPO2 of sacral tail,prealbumin were lower than those of non-pressure injury group,the differences were statistically significant(P<0.01).Multivariate logistic regression analysis showed that TcPO_(2)CV(OR=1.234,95%CI:1.138~1.337)and prealbumin(OR=0.969,95%CI:0.956~0.983)were independent risk factors and independent protective factors for PI,respectively(P<0.01).The best cutoff values of TcPO_(2)CV and prealbumin for monitoring stress injury were 21.63%and 116.1mg/L,respectively,and the area under the ROC curve(AUC)was 0.878 and 0.869.Conclusion:TcPO_(2)CV and prealbumin are valuable for PI risk prediction in Critical patients.They can be used as a new objective evaluation method to guide the early stage identification of PI in Critically ill patients.
作者
李莉
肖佩华
王雅萍
顾蓉蓉
范苏红
王晨
LI Li;XIAO Pei-hua;WANG Ya-ping;GU Rong-rong;FAN Su-hong;Wang Chen(Department of Nursing,Suzhou Ninth Hospital affiliated to Soochow University,Suzhou 215200,Jiangsu,China;Department of critical care medicine,Suzhou Ninth Hospital affiliated to Soochow University,Suzhou 215200,Jiangsu,China)
出处
《肠外与肠内营养》
CAS
CSCD
北大核心
2023年第1期45-50,共6页
Parenteral & Enteral Nutrition
基金
苏州大学附属苏州九院院级课题(YK202132)
关键词
胸骶经皮氧分压变异率
前白蛋白
重症病人
压力性损伤
预测作用
Variation coefficient of transcutaneous oxygen pressure
Prealbumin
Critically ill patients
Pressure injury
Predictive effect
作者简介
李莉,副主任护师,护理本科,主要从事危重症病人护理研究。E-mail:954790758@qq.com;通讯作者:肖佩华,E-mail:xph22@163.com
