徐洁 邓晓芳 潘晓云 陈瑜 孙彩霞

[摘要] 目的 通过对温州市某三甲综合性医院住院患者医院获得性压力性损伤的上报情况进行分析与总结，为医院获得性压力性损伤的预防和三级护理质量管理提供依据。 方法 回顾性收集该院三年医院获得性压力性损伤的发生情况，并进行相关因素分析。 结果 该院2017年1月至2019年12月医院获得性压力性损伤患者共628例，医院获得性压力性损伤（HAPI）的发生率为0.12%。医院获得性压力性损伤以2期（71.21%）为主，好发部位为骶尾部（42.28%），男性患者人数多于女性。ICU（18.95%）是发生医院获得性压力性损伤的高发科室。单因素分析结果显示，收缩压、舒张压、平均动脉压、体温、呼吸、白蛋白、血糖、血红蛋白、中性粒细胞百分数、钾离子、动脉血pH值、血清肌酐、氧分压和Braden評分比较，差异有统计学意义（P<0.05）。 结论 该院医院获得性压力性损伤发生率呈中下水平，男性较多，2期多见，骶尾部是最好发的部位，高发病区主要是急危重症监护室。与HAPI发生前相比，住院患者在发生HAPI后，收缩压和舒张压、平均动脉压、体温、呼吸、白蛋白、血糖、血红蛋白、中性粒细胞百分数、钾离子、动脉血PH值、血清肌酐、氧分压、Braden评分都有明显变化，为临床上观察HAPI的动态演变提供了一定的依据。

[关键词] 医院获得性压力性损伤;发生率;相关因素;预防

[中图分类号] R477.1          [文献标识码] B          [文章编号] 1673-9701（2021）34-0179-04

[Abstract] Objective To provide a basis for the prevention of hospital-acquired pressure injuries（HAPI） and tertiary nursing quality management by analyzing and summarizing the reported HAPI in inpatients of a tertiary general hospital in Wenzhou. Methods The occurrence of HAPI in this hospital was retrospectively collected for three years，and relevant factors were analyzed. Results There were 628 patients with HAPI in this hospital from January 2017 to December 2019，and the incidence of HAPI was 0.12%. HAPI was predominantly stage 2（71.21%），and the predilection site was the sacral tail （42.28%），with more male patients than female. The intensive care unit （ICU）（18.95%） was the high incidence department for the occurrence of HAPI. Univariate analysis showed that there were statistically significant differences in systolic blood pressure，diastolic blood pressure， mean arterial pressure， body temperature，respiration，albumin，glucose，hemoglobin，neutrophils percentage， potassium ions， pH of arterial blood， serum creatinine， partial pressure of oxygen， and Braden score. Conclusion The incidence of HAPI in this hospital is at the moderate to low level，with more male patients and more common in stage 2. The sacral tail is the predilection site，and high incidence area is mainly in the ICU. Compared with before the occurrence of HAPI， inpatients show significant changes in systolic and diastolic blood pressure， mean arterial pressure， body temperature， respiration， albumin，glucose，hemoglobin， neutrophils percentage， potassium ions， pH of arterial blood，serum creatinine， partial pressure of oxygen and Braden score after the occurrence of HAPI， which provides some basis for clinical observation of the dynamic evolution of HAPI.

[Key words] Hospital-acquired pressure injuries; Incidence; Related factors; Prevention

压力性损伤（Pressure injury，PI），即压疮，是指发生在皮肤和（或）皮下软组织的局限性损伤，通常出现在骨突处或皮肤与医疗器械设备接触处，可表现为完整的皮肤或开放性溃疡，可能伴有疼痛感[1]。医院获得性压力性损伤（Hospital acquired pressure injury，HAPI），又称院内压力性损伤，是世界各地住院患者最常发生的不良事件之一[2]。患病率和发病率被认为是评估卫生保健负担和护理质量的重要指标。确定医院获得性压力性损伤的患病率和发生率对于了解HAPI的严重程度、帮助决策者管理及改善医疗保健的规划、提高护理质量提供了非常重要的依据。……