CAJ | 학술논문

目的评价Braden评估表对神经内科卧床患者压疮的预测效果,探讨压疮分组预防措施效果.方法选取400例新人院、首次评估无压疮的神经内科卧床患者,应用Braden评估表动态评估发生压疮的危险性,将400例患者按评分分为高危、中危、低危及无危组4组各100例,并分别将高危、中危、低危组随机分为实验组和对照组各50例;对照组采取常规干预措施,高危实验组使用气垫床,中危实验组使用海绵床垫,低危实验组每4 h翻身1次,其他预防措施同对照组,无危险组不采取任何干预措施.结果 Braden评估表在首次和末次评分时ROC曲线下面积分别为0.771和0.828,诊断界值取17分时其对应灵敏度、特异度、阳性预测值、阴性预测值等指标均能达到较高水平.在分组干预中,高、中、低危实验组分别与对照组比较,各组压疮发生率均无显著差异.结论 Braden评估表对神经内科卧床患者压疮发生有较好的预测效果,17分是较理想的诊断界值.对神经内科压疮高危者采用气挚床、中度危险者采用海绵垫,压疮发生率降低不显著.低危者可采取每4 h翻身1次的方法以减少资源的消耗.
목적 평개Braden평고표대신경내과와상환자압창적예측효과,탐토압창분조예방조시효과.방법 선취400례신인원、수차평고무압창적신경내과와상환자,응용Braden평고표동태평고발생압창적위험성,장400례환자안평분분위고위、중위、저위급무위조4조각100례,병분별장고위、중위、저위조수궤분위실험조화대조조각50례;대조조채취상규간예조시,고위실험조사용기점상,중위실험조사용해면상점,저위실험조매4 h번신1차,기타예방조시동대조조,무위험조불채취임하간예조시.결과 Braden평고표재수차화말차평분시ROC곡선하면적분별위0.771화0.828,진단계치취17분시기대응령민도、특이도、양성예측치、음성예측치등지표균능체도교고수평.재분조간예중,고、중、저위실험조분별여대조조비교,각조압창발생솔균무현저차이.결론 Braden평고표대신경내과와상환자압창발생유교호적예측효과,17분시교이상적진단계치.대신경내과압창고위자채용기지상、중도위험자채용해면점,압창발생솔강저불현저.저위자가채취매4 h번신1차적방법이감소자원적소모.
Objective To evaluate the predictive effect of Braden scale for the risk of development of pressure ulcers (PU) in the department of neurology bedridden patients and to explore subgroup preventive measures. Methods 400 cases newly hospitalized bedridden patients in the department of neurology were collected with no pressure ulcers at the first evaluation and pressure ulcer risk was continuously predicted by a Braden scale skin assessment. The high-risk, middle-risk and low-risk groups were randomized into the experimental group and the control group respectively. Routine preventive measures were taken for the control group while the air fluidized bed for the high-risk group, the sponge mattress for the middle-riskgroup, and turning the body over every 4 hours for low-risk group. Other preventive procedures were undertaken simultaneously in beth the experimental and the control groups. Results The area under the ROC curve (AUC)was 0.771 and 0.828 at the first and last time Braden scale scores respectively. Such vMues as sensitiveness, specificity, positive predictive value, negative predictive value were found in higher level,when the diagnosis value was 17. There was no significant difference of incidence rate of the subgroup pressure ulcers between the high-risk, middle-risk, low-risk groups compared to the control group. Conclusions The effect of predicting pressure ulcer risk for bedridden patients in the department of neurology with Braden scale was fairly good, while the score 17 as the diagnosis value was ideal. The air fluidized bed for the high-risk group and the sponge mattress for the middle-risk group resulted in no significant decrease of incidence rate of the pressure ulcer, while taming over the patients' body every 4 hours for low-risk groups showed acceptable and therefore saving medical resources.