姜庆红，郎 萍，孙英芬

(宁波市第二医院，浙江 宁波 315010)

·临床护理与管理·

三级压疮监管体系在脑卒中患者中的应用

姜庆红，郎 萍，孙英芬

(宁波市第二医院，浙江 宁波 315010)

目的：探讨三级压疮监管体系在临床压疮管理中的应用效果。方法对临床压疮患者和压疮高危患者进行护理部—压疮专业组—科内压疮质控组部3级质控监管。结果本组110例患者使用该监管体系后，84例压疮高危患者仅2例发生压疮，26例压疮患者中19例愈合，7例好转。结论运用三级压疮监管体系，降低了高危压疮的发生率，提高了难免压疮的治愈率及护士的压疮专科知识水平。

三级监管；脑卒中；压疮

Abstract：[Objective] To discuss the effects of three-grade pressure ulcer administration system in clinical pressure ulcer management. [Method] The three-grade pressure ulcer administration system consists of nursing department, professional group of pressure ulcer and quality control group of clinical department. The administration supervise about pressure ulcer in three-grade quality control management was applied to patients with pressure ulcer and patients with higher risk. [Result] All of 110 patients were undertaken this management. Only 2 patients acquired pressure ulcer among 84 patients with higher risk.19 patients cured from pressure ulcer among 26 patients with pressure ulcer. 7 patients with pressure ulcer were on the mend. [Conclusion] With three-grade pressure ulcer administration system, the morbidity rate of pressure ulcer in higher risk patients had been reduced and the curative ratio of unavoidable pressure ulcer had been improved. The system consolidated professional knowledge of pressure ulcer of nurses.

Keywords: three-grade administration system; cerebral stroke; pressure ulcer

2007年，美国国家压疮顾问小组(NPUAP)将压疮的定义更新为[1]：压疮是皮肤或皮下组织由于压力、剪切力或摩擦力而导致的皮肤、肌肉和皮下组织的局限性损伤，常发生在骨隆突处。脑卒中多为老年人，发病后常有肢体感觉障碍、瘫痪、大小便失禁等表现，剪切力或摩擦力随时存在，是压疮的好发者。美国的压疮预防指南推荐应用Braden量表及Norton量表，尤其是Braden量表被认为其敏感性及特异性较为平衡，适用于老年及内外科病人，被认为是适用较广的量表[2]。新近研究表明[3]，住院患者压疮发生率为3%～12%，其中老年患者压疮发生率10%～25%，死亡率增加6倍。加强防治、杜绝好发因素是避免压疮发生的关键。本科室自2010年1月至2011年6月对84例压疮高危患者(Braden评分≤12分)及26例Ⅱ～Ⅲ期压疮患者的护理中融入压疮监管理念、全面监控，取得了较好的效果，汇报如下。……