CAJ | 학술논문

目的：探讨晚期肿瘤患者压疮发生的危险因素及其预防措施。方法2010年7月1日开始实行压疮报告制度，对肿瘤患者进行压疮风险评估，制订防治计划。收集2010年1月1日—6月30日收治的612例和2013年1月1日—6月30日收治的632例晚期肿瘤患者的临床资料，比较压疮防治措施实施前后的发生率，应用修订版Braden量表对肿瘤患者压疮发生的影响因素及严重程度进行评估。结果2010年上半年和2013年上半年患者压疮的发生率分别为23．9％和18．2％，差异有统计学意义（χ2＝4．80，P＜0．05）。2013年上半年压疮患者的平均年龄为（76．2±2．3）岁，明显大于无压疮患者的（66．1±2．0）岁，差异有统计学意义（ t ＝23．37，P ＜0．01）。压疮患者的修订版Braden 量表评分为（11．3±1．1）分，低于无压疮患者的（20．4±1．7）分，差异有统计学意义（ t＝27．12，P＜0．01）。压疮的严重程度与患者所处环境的潮湿程度、活动情况、行动能力和是否有摩擦力及剪切力相关（P＜0．01）。结论压疮报告制度和预防措施有效。对于有患压疮风险的患者，应当尽早进行风险评估和预防，以降低预见压疮的发生或减缓预见性压疮的发展程度。
목적：탐토만기종류환자압창발생적위험인소급기예방조시。방법2010년7월1일개시실행압창보고제도，대종류환자진행압창풍험평고，제정방치계화。수집2010년1월1일—6월30일수치적612례화2013년1월1일—6월30일수치적632례만기종류환자적림상자료，비교압창방치조시실시전후적발생솔，응용수정판Braden량표대종류환자압창발생적영향인소급엄중정도진행평고。결과2010년상반년화2013년상반년환자압창적발생솔분별위23．9％화18．2％，차이유통계학의의（χ2＝4．80，P＜0．05）。2013년상반년압창환자적평균년령위（76．2±2．3）세，명현대우무압창환자적（66．1±2．0）세，차이유통계학의의（ t ＝23．37，P ＜0．01）。압창환자적수정판Braden 량표평분위（11．3±1．1）분，저우무압창환자적（20．4±1．7）분，차이유통계학의의（ t＝27．12，P＜0．01）。압창적엄중정도여환자소처배경적조습정도、활동정황、행동능력화시부유마찰력급전절력상관（P＜0．01）。결론압창보고제도화예방조시유효。대우유환압창풍험적환자，응당진조진행풍험평고화예방，이강저예견압창적발생혹감완예견성압창적발전정도。
Objective To compare the prevalence of pressure ulcers and prevention before and after a quality improvement program.Methods Descriptive comparative study based on two cross-sectional pressure ulcer surveys was conducted in 2010 and 2013.A total of 612 hospitalized patients in 2010 and 632 in 2013 were included.The pressure ulcers prevention mainly included pressure-reducing mattresses, planned repositioning and so on.Braden scale was used to estimate the effect factors and severity of pressure ulcers. Results Pressure ulcer prevalence was 23.9%in 2010 and 18.2%in 2013,and the difference was statistically significant (χ2 =4.80,P<0.05).The mean age of patients with pressure ulcers in first half year of 2013 were significantly older than those without (76.2 ±2.3 vs 66.1 ±2.0;t=23.37,P<0.01).Braden scale records of pressure ulcers patients was lower than that of patients without (11.3 ±1.1 vs 20.4 ±1.7;t =27.12,P<0.01).The severity of pressure ulcers was related to moisture, activity, mobility and friction and shear (P<0.01).Conclusions Risk assessment as well as prevention should start early in the hospitalization in order to improve the life quality of patients.