黎艳娟 黄晓薇 邓伟征 陈佩群

[摘要]目的探讨波浪型水垫在预防腹腔镜全子宫切除术中压疮的应用效果。方法选取2019年1月至2020年1月于肇庆市高要区人民医院综合手术室行腹腔镜全子宫切除术的60例患者作为研究对象，依据随机数字表法分为观察组和对照组，每组各30例，两组患者均采用相同护理方法，观察组患者使用波浪型水垫，对照组患者使用普通海绵垫。观察术后3 d 时两组患者压疮发生率、受压处皮肤变化情况、舒适度[Kolcaba舒适状况量表（GCQ）]及生存质量[世界卫生组织生存质量测定量表简表（WHOQOL-BREF）]评分差异，比较两组患者护理满意度差异。结果术后3 d 时，两组患者压疮发生率比较，差异无统计学意義（ P >0.05）;两组患者受压处皮肤不良变化总发生率比较，差异无统计学意义（ P >0.05）;观察组 GCQ 中生理、心理精神、社会文化和环境评分均明显高于对照组（均 P <0.05）;观察组患者 PSYCH、PHYS、ENVIR 和 SOCIL 评分均明显高于对照组（均 P <0.05）;观察组患者护理总满意度明显高于对照组（ P <0.05）。结论波浪型水垫较普通海绵垫更利于降低行腹腔镜全子宫切除术患者压疮发生风险，其舒适度较佳，患者生存质量改善，且可提高患者对护理工作满意度，具有较高临床应用价值。

[关键词]腹腔镜全子宫切除术;波浪型水垫;压疮;护理满意度

[中图分类号] R713.4+2 [文献标识码] A  [文章编号]2095-0616（2021）22-0108-04

Application of wavy water cushion in preventing pressure sores during laparoscopic hysterectomy

LI  Yanjuan1    HUANG  Xiaowei2    DENG  Weizheng1    CHEN  Peiqun1

1.Operating Room， Nan'an Branch of People's Hospital of Gaoyao District in Zhaoqing City， Guangdong， Zhaoqing 526100， China;2.Department of Ophthalmology， People's Hospital of Gaoyao District in Zhaoqing City， Guangdong， Zhaoqing 526040， China

[Abstract] Objective To explore the application effect of wavy water cushion in preventing pressure sores during laparoscopic hysterectomy .Methods  A total of sixty patients who underwent laparoscopic hysterectomy in the comprehensive operating room of People's Hospital of Gaoyao District in Zhaoqing City from January 2019 to January 2020 were selected as the research objects， and they were divided into the observation group and the control group according to random number table method， with 30 cases in each group . Both groups adopted the same nursing methods . The observation group was given wave-shaped water cushion and the control group was given ordinary sponge cushion . Three days after operation， the differences in the incidence of pressure sores， skin changes at the compressed parts， comfort degree （Kolcaba General Comfort Questionnaire [GCQ]） and quality of life （WHOQOL-BREF） scores between the two groups were observed， and the differences in nursing satisfaction between the two groups were compared . Results Three days after operation， there was no significant difference in the incidence of pressure sores between the two groups （P >0.05）. There was no significant difference between the two groups in the total incidence of adverse skin changes at the compression site （P >0.05）. The scores of physiology， psychology， social culture and environment in GCQ of observation group were significantly higher than those of control group （P <0.05）. The scores of PSYCH， PHYS， ENVIR and SOCIL in observation group were significantly higher than those in control group （P <0.05）.The total nursing satisfaction of patients in observation group was significantly higher than that in control group （P <0.05）. Conclusion Compared with ordinary sponge cushion， the wavy water cushion is more beneficial to reduce the risk of pressure sores in patientsundergoing laparoscopic hysterectomy， which is more comfortable， and can improve patients' quality of life .It can improve the satisfaction of patients with nursing work， which has higher clinical application value .

[Key words] Laparoscopic hysterectomy; Wavy water cushion; Pressure sore; Nursing satisfaction

手术压疮是由于患者在手术期间保持体位固定不变，并且术中麻醉可导致患者对疼痛和运动敏感性降低或消失，引起自主调节功能减退，使骨隆突处或身体受压处血液循环障碍，破坏正常生理功能，发生组织破坏或坏死的现象[1]。因此，手术压疮在手术护理当中是一项难以攻坚的并发癥。有研究报道，手术压疮发生率可高达66%，压疮的发生增加患者痛苦和经济负担[2]。以往腹腔镜全子宫切除手术摆放体位时采用普通的……