摘要目的 探讨分级翻身法对ICU患者压疮的预防作用及对护理翻身-作量的影响.方法 将2015年3-9月入住重症医学科一病房的所有符合条件的患者按照随机数字表法分为对照组219例和试验组230例.对照组患者采用传统翻身法,即常规每2小时翻身1次;试验组患者采用分级翻身法:首先根据压疮危险因素(Braden评分和儿茶酚胺指数)将患者分为A、B、C三级,翻身频率分别为1、2、4 h.观察和比较2组患者压疮发生情况及翻身护理-作量.结果 最终有201例对照组患者和220例试验组患者纳入数据分析.试验组的压疮发生率为0,与对照组的0.1%(2/201)相比,差异无统计学意义(P>0.05);但试验组的皮肤压红发生率为1.36%(3/220),明显低于对照组的11.44%(23/201),差异有统计学意义(χ2=13.20,P<0.05).试验组每例患者平均每天翻身次数、翻身耗时分别为(7.22 ± 1.81)次、(42.09 ± 1.68)min,明显少于对照组的(11.38 ± 1.23)次、(66.35 ± 1.83)min,差异有统计学意义(t=6.563、5.210,均P<0.05).结论 分级翻身法可以有效预防重症患者压疮的发生,同时可减少ICU翻身护理-作量.

abstractsObjective To discuss the effect of grade repositioning designed by our team on preventing the development of pressure ulcers in ICU patients and its influence on nursing workload of repositioning. Methods Eligible patients admitted to ICU were randomly divided into control group (traditional repositioning,219 cases)and experimental group(grade repositioning,230 cases).The patients in control group was routinely repositioned every 2 hours;the patients in experimental group was classified as"A""B""C"three levels according to Braden Scores and catecholamine scores,and their repositioning frequency was 1 hour,2 hours and 4 hours respectively.Number of pressure ulcers and nursing workload of repositioning were observed and compared between the two groups. Results At last,the data analysis was included in 201 patients in control group and 220 patients in experimental group.There was no significant difference in the rate of pressure ulcer occurrence between the experimental group(0)and the control group[0.1%(2/201)](P>0.05).But the rate of skin redness occurrence was significant less in the experimental group than in the control group[1.36%(3/220)vs.11.44%(23/201), χ2=13.20,P<0.05]. The mean repositioning times for each patient in the experimental group was significantly less than the control group[(7.22±1.81)times/day vs.(11.38±1.23)times/day],and turn over time was(42.09±1.68)min and(66.35±1.83)min which was also significantly different(t=6.563, 5.210, P<0.05). Conclusion Grade repositioning could effectively prevent critically illed patients from the occurrence of pressure ulcers,while reducing the overall nursing workload of repositioning in an ICU.