影响老年慢性阻塞性肺疾病机械通气患者压力性损伤的相关危险因素分析

Analysis of related risk factors for pressure injury in elderly patients with COPD undergoing mechanical ventilation

中文关键词: 老年  慢性阻塞性肺疾病  机械通气  压力性损伤  风险因素

英文关键词: elderly  chronic obstructive pulmonary disease  mechanical ventilation  pressure injury  risk factor

中文摘要:

      目的 分析老年慢性阻塞性肺疾病(COPD)机械通气患者压力性损伤的危险因素.方法 回顾性分析2021年1月—2023年12月成都医学院第二附属医院收治的252例行机械通气的老年COPD患者的临床资料.根据患者机械通气期间是否发生压力性损伤分为压力性损伤组(60例)和无压力性损伤组(192例).对压力性损伤组患者的压力性损伤特点进行观察,使用单因素分析影响患者发生压力性损伤的危险因素,并使用多因素Logistic回归分析对诱发压力性损伤的独立危险因素进行分析.结果 压力性损伤组患者主要压力性损伤发生部位有头部10例(16.67％)、骶尾部35例(58.33％)、胸部8例(13.33％),压力性损伤分级主要为1期29例(48.33％)、2期24例(40.00％).单因素分析显示,2组的住院时间、是否存在意识障碍、是否调整通气体位、通气方法、血红蛋白水平和血清白蛋白水平差异均有统计学意义(P＜0.05);多因素Logistic回归分析显示,患者住院时间、是否调整通气体位、通气方法、血红蛋白水平和血清白蛋白水平是诱发机械通气压力性损伤的独立危险因素(P＜0.05).结论 老年COPD机械通气患者压力性损伤可能主要受住院时间、通气体位、通气方法、血红蛋白水平和血清白蛋白水平影响,且多发生于患者头部、骶尾部、胸部.

英文摘要:

      Objective To analyze the risk factors for pressure injury in elderly patients with chronic obstructive pulmo-nary disease(COPD)undergoing mechanical ventilation.Methods The clinical data of 252 elderly COPD patients who un-derwent mechanical ventilation in Second Affiliated Hospital of Chengdu Medical College from January 2021 to December 2023 were retrospectively analyzed.They were divided into pressure injury group(60 cases)and non-pressure injury group(192 ca-ses)according to whether pressure injury occurred during mechanical ventilation.The characteristics of pressure injury of pa-tients in the observation group were observed.Univariate analysis was used to analyze the risk factors affecting the occurrence of pressure injury,and multivariate Logistic regression analysis was used to analyze the independent risk factors inducing pres-sure injury.Results In the pressure injury group,the main sites of pressure injury were head in 10 cases(16.67％),sacro-coccygeal region in 35 cases(58.33％)and chest in 8 cases(13.33％).The main classification of pressure injury was stage 1 in 29 cases(48.33％)and stage 2 in 24 cases(40.00％).Univariate analysis showed that there were statistically significant differences in length of hospital stay,disturbance of consciousness,adjustment of ventilation position,ventilation mode,hemo-globin level and serum albumin level between the two groups(P＜0.05).Multivariate logistic regression analysis showed that the length of hospital stay,adjustment of ventilation position,ventilation mode,levels of hemoglobin level and serum albumin level were independent risk factors for pressure injury(P＜0.05).Conclusion Pressure injuries in elderly COPD patients un-dergoing mechanical ventilation may be mainly affected by the length of hospital stay,ventilation position,ventilation mode,hemoglobin level and serum albumin level.It occurs mostly in the head,sacrococcygeal region and chest of patients.