CAJ | 학술논문

目的探讨逐步延长翻身间隔时间对老年心力衰竭患者受压皮肤的影响。方法采用便利取样，选择老年心力衰竭患者60例，按照随机数字表法分为对照组和观察组各30例，对照组按常规方法120 min翻身1次，观察组第1周120 min翻身1次，后3周每周延长30 min，比较两组患者各期压疮发生率及翻身间隔时间为120，150，180，210 min两侧肩胛部、骶尾部的压力。结果随着翻身间隔时间的延长（120，150，180 min／次），观察组体表压力的变化，差异无统计学意义（ P＞0．05），但在实施第4周（210 min／次），观察组的左右肩胛部及骶尾处体表压力分别为（53．67±3．22），（52．71±4．19），（95．34±0．48）mmHg，高于其他间隔时间，差异有统计学意义（P＜0．05）；实施第1，2，3周两组骶尾部与两侧肩胛骨处平均体表压力值差异无统计学意义（P＞0．05），实施第4周观察组的左右肩胛部及骶尾处体表压力值高于对照组的（48．10±2．67）（47．94±5．10）（90．91±1．27）mmHg，差异有统计学意义（P＜0．05）；观察组30例患者发生压疮6例占20．00％，对照组5例占16．67％，两组均无一例发生Ⅲ期压疮，两组患者压疮发生率差异无统计学意义（Z＝0．074，P＞0．05）。结论将翻身间隔时间延长至180 min可以有效提高患者皮肤耐受性，在不引起压疮发生率的情况下，既减少了翻身给患者带来的不适感，又在一定程度上降低了护理人员的工作强度。
목적탐토축보연장번신간격시간대노년심력쇠갈환자수압피부적영향。방법채용편리취양，선택노년심력쇠갈환자60례，안조수궤수자표법분위대조조화관찰조각30례，대조조안상규방법120 min번신1차，관찰조제1주120 min번신1차，후3주매주연장30 min，비교량조환자각기압창발생솔급번신간격시간위120，150，180，210 min량측견갑부、저미부적압력。결과수착번신간격시간적연장（120，150，180 min／차），관찰조체표압력적변화，차이무통계학의의（ P＞0．05），단재실시제4주（210 min／차），관찰조적좌우견갑부급저미처체표압력분별위（53．67±3．22），（52．71±4．19），（95．34±0．48）mmHg，고우기타간격시간，차이유통계학의의（P＜0．05）；실시제1，2，3주량조저미부여량측견갑골처평균체표압력치차이무통계학의의（P＞0．05），실시제4주관찰조적좌우견갑부급저미처체표압력치고우대조조적（48．10±2．67）（47．94±5．10）（90．91±1．27）mmHg，차이유통계학의의（P＜0．05）；관찰조30례환자발생압창6례점20．00％，대조조5례점16．67％，량조균무일례발생Ⅲ기압창，량조환자압창발생솔차이무통계학의의（Z＝0．074，P＞0．05）。결론장번신간격시간연장지180 min가이유효제고환자피부내수성，재불인기압창발생솔적정황하，기감소료번신급환자대래적불괄감，우재일정정도상강저료호리인원적공작강도。
Objective To discuss the effect of gradually prolonging interval time of repositioning on the pressed skin of elderly patients with chronic heart failure .Methods Convenience sampling was used to choose 60 elderly patients with chronic heart failure , who were randomly divided in the observation group and the control group, each with 30 cases.The control group was repositioned once for 120 min according to the conventional method , while the observation group was repositioned once for 120 min for a week and then 30 min prolonged the next 3 weeks.Incidence rate of pressure ulcers and pressure on both scapular and sacrococcygeal regions with interval time of 120 min, 150 min, 180 min and 210 min were compared between two groups . Results The pressure had no statistically significant difference in the observation group among interval time of 120 min, 150 min and 180 min, however , the pressure on both scapular and sacrococcygeal regions with interval time of 210 min was respectively (53.67 ±3.22),(52.71 ±4.19),(95.34 ±0.48)mmHg, higher than those with other interval times, and the differences were statistically significant (P<0.05).There was no statistically significant difference of pressure on both scapular and sacrococcygeal regions during the first , second and third week between two groups .The pressures, however, were higher in the observation group than in the control group [(48.10 ±2.67)(47.94 ±5.10)(90.91 ±1.27)mmHg] during the fourth week, and the differences were statistically significant (P<0.05).The incidence rate of pressure ulcers was 20.00% in the observation group and 16 .67%in the control group , and both groups had no phase Ⅲpressure ulcers , with no statistically significant difference (Z=0.074, P>0.05).Conclusions Prolonging the interval time of repositioning to 180 min can effectively improve the skin tolerance of elderly patients with chronic heart failure , reduce their discomfort as well as nurses ’ workload without incidence of pressure ulcers .