两种体位支撑用具标准化摆放方法的减压效果评价

doi:10.3761/j.issn.1672-9234.2022.01.012

摘要/Abstract

摘要：

目的评价平卧位和侧卧位两种体位支撑用具标准化摆放方法的减压效果。方法采用自身对照方法,在采取平卧位和侧卧位两种体位的情况下,对40名健康受试者分别采用基于指南形成的支撑用具标准化摆放与常规摆放两种方法,测量受试者与床面接触的身体主要受压部位(枕后、耳廓、肩胛、髋部、骶尾部、膝关节、足跟)的平均压强峰值、压力。结果平卧位及侧卧位支撑用具的常规摆放方法的平均压强峰值均大于基于指南形成的支撑用具标准化摆放方法的平均压强峰值(P<0.001),常规摆放方法的受压点平均压力均大于基于指南形成的支撑用具标准化摆放方法的平均压力(P<0.05)。结论应用基于指南形成的支撑用具标准化摆放方法可以降低受压点压力,但对部分受压部位仍需重点关注。

关键词: 指南, 体位, 压力, 支撑用具

Abstract:

Objective To evaluate the effects of support devices placed in a standard way on pressure reduction in supine position and lateral decubitus. Methods The study adopted a self-control study design. Forty healthy participants were placed in the supine position and the lateral decubitus respectively with the supporting devices placed in two methods：the standard placement based on the guideline and the routine placement. The average peak pressure and pressure of the main body parts (occipital posterior,auricle,scapula,hip,sacral tail,knee and heel) were measured. Results Routine placement of supporting devices in both positions could produce greater mean peak pressure than the standard placement of supporting devices(P<0.001). Besides,pressure produced by routine placement of supporting devices in both positions was also higher than that of the standard placement of supporting devices (P<0.05). Conclusion The standard placement of supporting devices based on guideline can reduce the pressure of compression body parts. However,some compression parts still need to be paid attention to.

Key words: Guideline, Position, Pressure, Supporting devices

周玉洁, 朴玉粉, 裴琛, 路潜, 李蕙杰, 杨聪颖. 两种体位支撑用具标准化摆放方法的减压效果评价[J]. 中华护理教育, 2022, 19(1): 70-74.

ZHOU Yu-jie, PIAO Yu-fen, PEI Chen, LU Qian, LI Hui-jie, YANG Cong-ying. The effects of supporting devices placed in a standard way on pressure reduction in two positions[J]. Chinese Journal of Nursing Education, 2022, 19(1): 70-74.

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参考文献 16

[1]	Grap MJ, Schubert CM, Munro CL, et al. OR time and sacral pres-sure injuries in critically ill surgical patients[J]. Aorn J, 2019, 109(2):229-239. doi: 10.1002/aorn.2019.109.issue-2
[2]	褚万立, 郝岱峰. 美国国家压疮咨询委员会2016年压力性损伤的定义和分期解读[J]. 中华损伤与修复杂志(电子版), 2018, 13(1):64-68.
	Chu WL, Hao DF. Interpretation of pressure injury’s definition and staging system of National Pressure Ulcer Advisory Panel in 2016[J]. Chin J Injury Repair and Wound Healing(Elec-tronic Edition), 2018, 13(1):64-68.
[3]	黄秋霞, 王建宁, 汤利萍, 等. 支撑用具预防压力性损伤的研究现状[J]. 护理学杂志, 2018, 33(1):97-100.
	Huang QX, Wang JN, Tang LP, et al. A literature review of support surface for pressure injury prevention[J]. J Nurs Sci, 2018, 33(1):97-100.
[4]	European Pressure Ulcer Advisory Panel, National Pressure In-jury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries:clinical practice guideline[EB/OL].(2019-11-15)[2020-07-01]. https://npiap.com/page/Guidelines.
[5]	Latimer S, Chaboyer W, Gillespie B. Pressure injury prevention strategies in acute medical inpatients:an observational study[J]. Contemp Nurse, 2016, 52(2/3):326-340. doi: 10.1080/10376178.2016.1190657
[6]	王璟, 邓颖, 胡秀兰. R型枕在神经科介入术后制动腰背部酸痛病人中的应用效果[J]. 循证护理, 2018, 4(9):853-857.
	Wang J, Deng Y, Hu XL. Application of R-type pillow for posto-perative brake in patients with lower back pain after neurosurgical intervention[J]. Evidence-based Nursing, 2018, 4(9):853-857.
[7]	赵卓, 周学颖, 张艳秋, 等. 高分子体位垫在双髋关节置换术中应用价值的研究[J]. 中国实验诊断学, 2015, 19(4):667-668.
	Zhao Z, Zhou XY, Zhang YQ, et al. Study on the application value of polymer position pad in double hip arthroplasty[J]. China Laboratory Diagnostics, 2015, 19(4):667-668.
[8]	杨丽芬, 朱宝才. 透明贴膜联合“R”型翻身枕在压疮高危患者中的应用[J]. 当代护士, 2018, 25(1):145-146.
	Yang LF, Zhu BC. Application of transparent lamination combined with“R” type turning pillow in high-risk patients with pressure ulcers[J]. Modern Nurse, 2018, 25(1):145-146.
[9]	Fontaine R, Risley S, Castellino R, et al. A quantitative analysis of pressure and shear in the effectiveness of support surfaces[J]. Wound Care, 1998, 25(5):233-239.
[10]	蒋琪霞, 朱亚君, 贾静, 等. 两种减压床垫对手术后患者压疮预防效果比较的随机对照试验[J]. 解放军护理杂志, 2015, 32(5):20-24,57.
	Jiang QX, Zhu YJ, Jia J, et al. Randomized controlled trial of two reduced pressure mattress in preventing pressure ulcer in surgical patients[J]. Nurs J Chin PLA, 2015, 32(5):20-24,57.
[11]	黄丽丹, 卢巧梅, 叶乃眉. R形翻身垫在ICU患者预防骶尾部压疮中的效果观察[J]. 当代护士, 2018, 25(5):141-143.
	Huang LD, Lu QM, Ye NM. Effect of R-shaped turning pad on prevention of sacral tail pressure ulcers in ICU patients[J]. Modern Nurse, 2018, 25(5):141-143.
[12]	Bergstrom N, Horn SD, Rapp M, et al. Preventing pressure ulcers:a multisite randomized controlled trial in nursing homes[J]. Ont Health Technol Assess Ser, 2014, 14(11):1-32.
[13]	任之珺, 夏欣华, 程安琪, 等. 力学因素致压力性损伤的预防新进展[J]. 护理研究, 2017, 31(10):1167-1170.
	Ren ZJ, Xia XH, Cheng AQ, et al. New progress on prevention of stress injury caused by mechanical factor[J]. Chin Nurs Res, 2017, 31(10):1167-1170.
[14]	周青, 刘媛, 冯尘尘, 等. 广东省25家综合医院压疮现患率调查分析[J]. 中国护理管理, 2017, 17(7):907-909.
	Zhou Q, Liu Y, Feng CC, et al. The prevalence of pressure ulcer among 25 general hospitals in Guangdong province[J]. Chin Nurs Manag, 2017, 17(7):907-909.
[15]	张亚楠, 李贤, 秦占芬, 等. 院内压疮临床发生特点的回顾性研究[J]. 全科护理, 2017, 15(22):2769-2771.
	Zhang YN, Li X, Qin ZF, et al. Clinical characteristics of pre-ssure ulcers in hospital:a retrospective study[J]. Gen Nurs, 2017, 15(22):2769-2771.
[16]	贾晓明. 压疮的流行病学特点及诊断与治疗进展[J]. 中华损伤与修复杂志(电子版), 2018, 13(1):4-7.
	Jia XM. Epidemiology characteristics and diagnosis and treatment progress of pressure ulcer[J]. Chin J Injury Repair and Wound Healing (Electronic Edition), 2018, 13(1):4-7.