泡沫敷料、水胶体敷料及棉垫预防监护室持续无创通气老年患者鼻面部压疮的效果

颜海珠 韩婷清 王俊美

【摘要】 目的：探討不同时期泡沫敷料、水胶体敷料及棉垫对于监护室持续无创通气老年患者鼻面部压疮的预防效果。方法：选择笔者所在医院2018年6月-2019年6月接收的监护室持续无创通气老年患者90例为对象，采用随机数字表法将患者分成泡沫组、水胶体组和棉垫组，每组30例。分别使用泡沫敷料（泡沫组）、水胶体敷料（水胶体组）和棉垫（棉垫组），比较三组患者入监护室第1、2周鼻面部压疮发生率和总发生率，调查患者的敷料舒适度。结果：第1周，三组患者的鼻面部压疮发生率比较差异无统计学意义（P>0.05）;第2周泡沫组、水胶体组患者的鼻面部压疮发生率比较差异无统计学意义（P>0.05），但均低于棉垫组，差异均有统计学意义（P<0.05）;泡沫组与水胶体组患者的鼻面部压疮总发生率均低于棉垫组，差异均有统计学意义（P<0.05）。泡沫组和水胶体组患者的总舒适度比较差异无统计学意义（P>0.05），但均高于棉垫组，差异均有统计学意义（P<0.05）。结论：监护室无创通气老年患者鼻面部压疮预防可用泡沫敷料或水胶体敷料，根据患者的具体情况选择。

【关键词】 持续无创通气 监护室 老年人 鼻面部压疮 预防方法

doi：10.14033/j.cnki.cfmr.2020.13.063 文献标识码 B 文章编号 1674-6805（2020）13-0-03

Foam Dressing， Hydrocolloid Dressing and Cotton Pads Prevent Nasal and Facial Pressure Ulcers in Elderly Patients with Continuous Noninvasive Ventilationin Monitoring Room/YAN Haizhu， HAN Tingqing， WANG Junmei. //Chinese and Foreign Medical Research， 2020， 18（13）： -154

[Abstract] Objective： To explore the effects of foam dressing， hydrocolloid dressing and cotton pads in preventing nasal and facial pressure ulcers in elderly patients with continuous noninvasive ventilation in different periods in monitoring rooom. Method： A total of 90 elderly patients with continuous noninvasive ventilation received in our hospital from June 2018 to June 2019 were selected as subjects. Random number table method was used to divide the patients into foam group， hydrocolloid group and cotton pad group， 30 cases in each group. During the first and second weeks when patients entered the monitoring room， foam dressings （foam group）， hydrocolloid dressings （hydrocolloid group）， and cotton pads （cotton pad group） were used to compare the incidence of nasal facial pressure ulcers and the total incidence among the three groups， and the patients dressing comfort were surveyed. Result： There were no differences in the incidence of nasal facial pressure ulcers among the three groups of patients in the first week （P>0.05）. There was no difference in the incidence of nasal facial pressure ulcers in the foam group and hydrocolloid group in the second week （P>0.05）， but both in which were lower than than in the cotton pad group， the differences were statistically significant （P<0.05）. The total incidence of nasal facial pressure ulcers in the foam group and the hydrocolloid group were lower than that in the cotton pad group， the differences were statistically significant （P<0.05）. There was no difference in total comfort between patients in the foam group and hydrocolloid group （P>0.05）， but both in which were higher than that in the cotton pad group， the differences were statistically significant （P<0.05）. Conclusion： Foam dressing or hydrocolloid dressing can be used to prevent nasal and facial pressure ulcers in elderly patients with noninvasive ventilation in the monitoring room.

[Key words] Continuous noninvasive ventilation Monitoring room Elderly Nasal and facial pressure ulcers Prevention methods

First-authors address： Zhanjiang Central Peoples Hospital， Zhanjiang 524000， China

无创呼吸机辅助患者通气的有效实现，与患者长期佩戴口鼻部面罩的情况密切相关，这也是患者出现鼻面部压疮的关键，主要是因为面罩会压迫面部，致使局部血液运行被阻，加上呼气、汗液等因素会导致面部皮肤潮湿，从而致使患者的鼻面部发生不同程度的压疮[1]。近年临床上关于持续无创通气患者鼻面部压疮预防的方法较多，但每种方法的适应性和局限性存在一定程度的差异，用于老年患者的效果也不同[2-3]。本次对笔者所在医院监护室持续无创通气的老年患者用不同方法预防鼻面部壓疮的临床情况进行分析，了解和记录监护第1、2周患者出现鼻面部压疮的情况，现报告如下。