基于问题导向的预警干预对脑梗死后卧床患者压疮预防的效果

摘要/Abstract

摘要： 目的探讨基于问题导向的预警干预对脑梗死后卧床患者压疮预防的效果。方法前瞻性选取2021年3月—2024年3月赤峰市医院收治的80例脑梗死后卧床患者作为研究对象,根据随机数表法将患者分为观察组和对照组,每组40例。对照组实施预警干预,观察组实施基于问题导向的预警干预,持续干预7 d后评估干预效果。分别于干预前、干预7 d后比较两组患者压疮风险[采用压疮评分量表（Braden）评估],干预7 d后,评价患者的卧床舒适度（参照Kolcaba的舒适状况量表并结合脑梗死后卧床患者情况拟定卧床舒适度评价表评估）;统计两组患者院内卧床治疗期间压疮发生情况。结果干预7 d后,两组Braden各维度评分降低,且观察组低于对照组,差异有统计学意义（P<0.05）。干预7 d后,观察组总舒适比例高于对照组,差异有统计学意义（P<0.05）。观察组压疮发生率低于对照组,差异有统计学意义（P<0.05）。结论脑梗死后卧床患者实施基于问题导向的预警干预,能够降低压疮风险,减少压疮发生,患者卧床舒适度提高。

关键词: 脑梗死, 压疮, 预警干预, 问题导向, 舒适度

Abstract: Objective To explore the effect of problem oriented early warning intervention on the prevention of pressure ulcers in bedridden patients after cerebral infarction. Methods A prospective study was conducted on 80 bedridden patients with cerebral infarction admitted to Chifeng Municipal Hospital from March 2021 to March 2024. According to the random number table method, patients were divided into an observation group and a control group, with 40 cases in each group. The control group received early warning intervention, while the observation group received problem oriented early warning intervention. The intervention effect was evaluated after 7 days of continuous intervention. The risk of pressure ulcer was compared between the two groups before intervention and after 7 days of intervention [assessed by pressure ulcer score scale (Braden)]. After 7 days of intervention, the bed comfort of patients was evaluated [according to Kolcaba's comfort scale (GCQ) and combined with the situation of bedridden patients after cerebral infarction to develop bed comfort evaluation table]. The occurrence of pressure sores during in-hospital bed rest treatment was counted in the two groups. Results After 7 days of intervention, the scores of each dimension of the Braden scale decreased in both groups of patients, and the observation group was lower than the control group, with a statistical significant difference (P<0.05). After 7 days of intervention, the proportion of total comfort in the observation group was higher than that in the control group (P<0.05). The incidence of pressure ulcers in the observation group was lower than that in the control group, with a statistical significant difference (P<0.05). Conclusion Implementing problem oriented early warning interventions for bedridden patients after cerebral infarction can reduce the risk of pressure ulcers, reduce the occurrence of pressure ulcers, and improve patient bed comfort.

Key words: cerebral infarction, pressure ulcers, early warning intervention, problem oriented, comfort level

中图分类号:

R473.5

齐莉. 基于问题导向的预警干预对脑梗死后卧床患者压疮预防的效果[J]. 中华养生保健, 2025, 43(7): 157-161.

QI Li. The Effect of Problem Oriented Early Warning Intervention on the Prevention of Pressure Ulcers in Bedridden Patients after Cerebral Infarction[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(7): 157-161.

参考文献

[1] 杨盼盼. 急诊ICU重症脑梗死患者压疮发生的相关因素研究[J].医药论坛杂志,2023,44(3):87-90.
[2] 高素颖,秦一凡,于凯,等.急性脑梗死患者神经功能缺损程度与压疮评分和跌倒评分的相关性研究[J].北京医学,2021,7(12):1201-1204.
[3] 周巍. 压疮预警干预机制联合问题导向的护理干预对重症昏迷患者压力性损伤的影响[J].中国医药指南,2022,20(25):176-178.
[4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[5] 巫嘉陵,王纪佐,王世民,等.脑卒中患者临床神经功能缺损程度评分的信度与效度[J].中华神经科杂志,2009,42(2):75-78.
[6] 任昱燊,刘启帆,郝艳华,等.压力性损伤风险评估工具的汉化及信效度检验[J].中国实用护理杂志,2018,34(35):2775-2779.
[7] 朱丽霞,高凤莉,罗虹辉,等.舒适状况量表的信效度测试研究[J].中国实用护理杂志,2006,22(13):57-59.
[8] 杨芳,沈菲,汪芸玏,等.基于问题导向的整体护理干预对老年冠心病患者遵医行为及疾病知识掌握度的影响[J].中国医药导报,2021,18(34):161-168.
[9] 周巍. 压疮预警干预机制联合问题导向的护理干预对重症昏迷患者压力性损伤的影响[J].中国医药指南,2022,20(25):176-178.
[10] 鄢祖霞. 压疮风险预警护理对重症脑梗死患者压力性损伤的预防效果分析[J].基层医学论坛,2023,27(18):145-147.
[11] 范凤云,杨超.压疮风险预警护理对ICU重症脑梗死患者压疮的预防效果[J].湖南中医药大学学报,2020,17(1):188-190.
[12] 李颖. 压疮风险预警护理在重症脑梗死患者预防压疮中的应用[J].当代临床医刊,2020,33(1):3231-3232.
[13] 杨艳丽. 压疮风险预警护理模式在预防重症脑梗死住院患者压疮发生中的应用价值[J].罕少疾病杂志, 2019, 26(6):106-108.
[14] 龚霞玲,刘英,许配配.压疮风险预警系统对老年患者术后康复期间医院获得性压疮的预防效果[J].中国当代医药, 2022,29(7):180-183.
[15] 杨玉萍. 重症脑梗死住院患者预防压力性损伤风险预警护理的临床研究[J].中外医疗,2020,39(32):161-163.