ICU脓毒血症患儿压力性损伤发生状况及其影响因素分析

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摘要目的观察ICU脓毒血症患儿压力性损伤发生状况，分析其发生的影响因素。方法选取2018年5月至2019年12月四川大学华西医院收治重症监护病房（ICU）的82例脓毒血症患儿，依据有无发生压力性损伤将其分为发生组（18例）和未发生组（64例），比较两组主要临床资料，采用多因素logistic回归分析压力性损伤发生的影响因素。结果本研究结果显示压力性损伤发生率为21.95%。发生组使用机械通气占比、嗜睡和昏迷占比、医疗设备使用＞2种占比、白细胞介素-6（IL-6）水平均高于未发生组，白蛋白、血红蛋白水平均低于未发生组，差异均有统计学意义（均P ＜ 0.05）。多因素logistic回归分析结果显示，医疗设备使用＞2种、机械通气、低白蛋白和血红蛋白水平均是ICU脓毒血症患儿发生压力性损伤的危险因素（均OR ＞ 1，P ＜ 0.05）；低IL-6水平是ICU脓毒血症患儿发生压力性损伤的保护因素（OR ＜ 1，P ＜ 0.05）。结论机械通气、医疗设备使用＞2种、低白蛋白和血红蛋白水平均会增加ICU脓毒血症患儿压力性损伤发生风险，低IL-6水平则可降低其发生的风险，临床应重视并在早期给予合理预防干预，以减少压力性损伤的发生。

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	周倩冯梅▲

关键词 ：脓毒血症, 重症监护病房, 压力性损伤, 机械通气, 血红蛋白, 白蛋白, 白细胞介素-6

Abstract：Objective To observe the occurrence of pressure injury in children with pyemia in ICU, and to analyze its influencing factors. Methods A total of 82 children with pyemia in intensive care unit (ICU) admitted to West China Hospital, Sichuan University from May 2018 to December 2019 were selected as the research subjects, they were divided into the occurrence group (18 cases) and the non-occurrence group (64 cases) according to whether pressure injury occurred. The main clinical data of the two groups were compared, and multivariate logistic regression was used to analyze the influencing factors of pressure injury. Results The results of this study showed that the incidence of pressure injury was 21.95%. The proportions of mechanical ventilation, proportions of drowsiness and coma, the proportions of using more than two kinds of medical equipment and interleukin-6 (IL-6) level in the occurrence group were higher than those in the non-occurrence group, the levels of albumin and hemoglobin were lower than those in the non-occurrence group, and the differences were statistically significant (all P ＜ 0.05). Multivariate logistic regression analysis showed that using two kinds of medical equipment, mechanical ventilation, low albumin and hemoglobin levels were the risk factors for pressure injury in children with pyemia in ICU (all OR ＞ 1, P ＜ 0.05). Low IL-6 level was a protective factor for pressure injury in children with pyemia in ICU (OR < 1, P < 0.05). Conclusion Mechanical ventilation, using more than two kinds of medical equipment, and low levels of albumin and hemoglobin all increase the risk of pressure injury in children with pyemia in ICU. Low IL-6 level can reduce the risk of its occurrence, and clinical attention should be paid to early rational prevention and intervention to reduce the occurrence of pressure injury.

Key words： Pyemia Intensive care unit Pressure injury Mechanical ventilation Hemoglobin Albumin Interleukin-6

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引用本文:

周倩冯梅▲. ICU脓毒血症患儿压力性损伤发生状况及其影响因素分析[J]. 中国医药导报, 2021, 18(19): 110-113.
ZHOU Qian FENG Mei▲. Analysis of the occurrence of pressure injury and its influencing factors in children with pyemia in ICU. 中国医药导报, 2021, 18(19): 110-113.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I19/110

[1] 张文喜，段达荣，张震宇，等.参附注射液联合低分子肝素对小儿脓毒血症血浆NT-ProBNP、Cys、凝血功能和预后的影响[J].中国现代医学杂志，2017，27（2）：61-65.
[2] Chun X，Lin Y，Ma JX，et al. Predictive efficacy of the Braden Q Scale for pediatric pressure ulcer risk assessment in the PICU：a meta-analysis [J]. Pediatr Res，2019， 86（4）：436-443.
[3] Peterson J，Adlard K，Walti BI，et al. Clinical Nurse Specialist Collaboration to Recognize，Prevent，and Treat Pediatric Pressure Ulcers [J]. Clin Nurse Spec，2015，29（5）：276-282.
[4] 瞿小龙，黄慧，李来娟，等.儿童压力性损伤风险评估工具和影响因素研究进展[J].中华现代护理杂志，2020，26（29）：4136-4139.
[5] 中国医师协会急诊医师分会，中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南（2018）[J].中国急救医学，2018，38（9）：741-756.
[6] Edsberg LE，Black JM，Goldberg M，et al. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System：Revised Pressure Injury Staging System [J]. J Wound Ostomy Continence Nurs，2016，43（6）：585-597.
[7] Levy A，Kopplin K，Gefen A. Adjustability and adaptability are critical characteristics of pediatric support surfaces [J]. Adv Wound Care，2015，4（10）：615-622.
[8] 刘新，陈红，冯鑫.急诊重症监护室成人患者医疗设备相关压力性损伤调查[J].中国护理管理，2019，19（8）：1222-1225.
[9] Labeau SO，Afonso EP，Serra ML. Pressure Injury Research in the ICU：Getting Rid of a Black Spot [J]. Crit Care Med，2019，47（2）：e161-e162.
[10] 赵燕.压疮护理的研究现状[J].中国临床研究，2010，23（8）：75-77.
[11] Manning MJ，Gauvreau K，Curley MAQ. Factors associated with occipital pressure ulcers in hospitalized infants and children [J]. Am J Crit Care，2015，24（4）：342-348.
[12] 李环，江仕爽，俞群，等.重症监护室患儿压力性损伤发生特征及影响因素分析[J].中华护理杂志，2018，53（3）：261-266.
[13] Black J，Alves P，Brindle CT，et al. Use of wound dressings to enhance prevention of pressure ulcers caused by medical devices [J]. Int Wound J，2015，12（3）：322-327.
[14] 李思情，胡爱玲.新生儿重症监护病房医疗器械相关压力性损伤的研究进展[J].华西医学，2019，34（2）：112-116.
[15] 杨莹，陈嘉萍，潘颖欣，等.头面部手术患者术中压力性损伤的影响因素及护理措施[J].实用医学杂志，2020， 36（21）：122-125.
[16] 郭军平，刘改芬，鞠奕，等.脑出血急性期患者住院期间压力性损伤发生的危险因素分析[J].中国卒中杂志，2019， 14（10）：1015-1018.
[17] 姚秀英，耿丽，张理，等.ICU患者压力性损伤预测风险列线图模型的建立[J].护理学报，2019，26（11）：55-59.
[18] Lim S，Kim BD，Kim JYS，et al. Preoperative Albumin Alone is Not a Predictor of 30-Day Outcomes in Pressure Ulcer Patients：A Matched Propensity-Score Analysis of the 2006-2011 NSQIP Datasets [J]. Ann Plast Surg，2015，75（4）：439-447.
[19] 陈素云，赵志新，颜海希，等.中性粒细胞与淋巴细胞比率和前白蛋白对脓毒血症患者预后评价研究[J].中国卫生检验杂志，2019，29（20）：2524-2533.
[20] 赵梅青，王芳.过敏性紫癜患者血清IL-6、IL-8、TNF-α及VEGF水平的研究[J].中国临床研究，2012，25（7）：649-650.
[21] 郭敏，杜建新.创伤性湿肺患者IL-6、IL-10与INF-γ水平与危重程度的关系研究[J].解放军预防医学杂志，2019，37（3）：82-84.
[22] 赵雪峰，魏秀华.脓毒血症患者血清IL-6以及IL-10的表达及对免疫功能的影响[J].中国实验诊断学，2017， 21（2）：279-281.
[23] 农礼荣，邓贺文，黄庆萍，等.集束化护理干预方案在ICU医疗器械相关性压力性损伤中的应用效果[J].中国当代医药，2020，27（27）：188-191.
[24] Eliades C. Mitigating Infant Medical Trauma in the NICU：Skin-to-Skin Contact as a Trauma-Informed，Age-Appropriate Best Practice [J]. Neonatal Netw，2018，37（6）：343-350.
[25] 徐雲，蒋红，赵琦.ICU医疗器械相关压力性损伤研究进展[J].上海护理，2018，18（4）：55-59.