目的 分析康复医学科脊髓损伤患者住院期间皮肤损伤的发生率及相关危险因素。 方法 回顾性分析2021年1月至2023年6月由江苏省人民医院钟山康复分院收治的120例脊髓损伤患者的资料，收集患者住院期间皮肤损伤的发生情况、类型、部位及护理干预等信息，分析康复科脊髓损伤患者皮肤损伤的发生率及特点。按患者住院期间是否发生皮肤损伤，分为皮肤损伤组(33例)和对照组(87例)。统计两组患者入院时的一般情况、损伤和功能情况、合并症、康复和护理措施等资料，比较上述因素的组间差异，并应用多因素Logistic回归分析筛选出康复科脊髓损伤患者住院时发生皮肤损伤的危险因素。 结果 120例脊髓损伤患者中，有33例(27.5%)发生皮肤损伤，共发生46次皮肤损伤，其中擦伤发生27次(58.7%)、压力性损伤10次(21.7%)、撕裂伤5次(10.9%)、烫伤4次(8.7%)。皮肤损伤发生部位多集中在肢体(65.2%)，其次是臀部和骶尾部(34.8%)。47.8%的皮肤损伤护理干预时间达到7 d以上。两组患者在住院时间、功能障碍、入院方式、压力性损伤风险、营养和辅助排尿方面比较，差异有统计学意义(P<0.05)。组间比较未发现脊髓损伤节段和严重程度分级等因素存在显著差异(P>0.05)。多因素Logistic回归分析显示，康复科脊髓损伤患者发生皮肤损伤与住院时间[OR＝1.015，95%CI(1.005，1.025)，P＝0.003]、压力性损伤发生风险[OR＝15.129，95%CI(1.370，167.066)，P＝0.027]、营养水平[OR＝6.181，95%CI(1.185，32.243)，P＝0.031]有关。 结论 康复科脊髓损伤患者住院期间皮肤损伤的发生率较高，住院时间长、有压力性损伤发生风险和营养水平差是患者发生皮肤损伤的独立危险因素。对于住院时间较长、入院评估有压力性损伤发生风险和营养差的患者，需要进一步加强皮肤管理的宣教，减少皮肤损伤对康复训练的影响。 Objective To observe the rate of skin injury after spinal cord injury (SCI) in the rehabilitation department and analyze its risk factors. Methods A total of 120 SCI patients were divided into an injury group of 33 and a control group of 87 without injury. The occurrence, type and location of any skin injuries incurred during hospitalization were recorded along with the subjects′ general condition, injury and functional status, complications, and the rehabilitation and nursing measures applied. Multivariate logistic regressions were evaluated to identify the risk factors for skin injury. Results Among the 33 injuries, 27 were bruises (58.7%), 10 were stress injuries (21.7%), 5 were lacerations (10.9%) and 4 were burns (8.7%). Most injuries (65.2%) were to the limbs, followed by the buttocks and the sacrococcygeal tail (34.8%). All of the skin injuries required nursing intervention, with 47.8% lasting more than 7 days. There were significant differences between the two groups in terms of their average hospital stay, dysfunction, mode of admission, risk of pressure injury, nutrition and assisted urination. The regressions identified significant relationships between the occurrence of skin injury and length of hospital stay, risk of pressure injury and nutrition. Conclusions The incidence of skin injury is high among hospitalized SCI patients. A long hospital stay, pressure injury and poor nutrition are independent risk factors for such patients. Such patients should receive skin management education.
Risk factors for skin injuries after a spinal cord injury
Objective To observe the rate of skin injury after spinal cord injury (SCI) in the rehabilitation department and analyze its risk factors. Methods A total of 120 SCI patients were divided into an injury group of 33 and a control group of 87 without injury. The occurrence, type and location of any skin injuries incurred during hospitalization were recorded along with the subjects′ general condition, injury and functional status, complications, and the rehabilitation and nursing measures applied. Multivariate logistic regressions were evaluated to identify the risk factors for skin injury. Results Among the 33 injuries, 27 were bruises (58.7%), 10 were stress injuries (21.7%), 5 were lacerations (10.9%) and 4 were burns (8.7%). Most injuries (65.2%) were to the limbs, followed by the buttocks and the sacrococcygeal tail (34.8%). All of the skin injuries required nursing intervention, with 47.8% lasting more than 7 days. There were significant differences between the two groups in terms of their average hospital stay, dysfunction, mode of admission, risk of pressure injury, nutrition and assisted urination. The regressions identified significant relationships between the occurrence of skin injury and length of hospital stay, risk of pressure injury and nutrition. Conclusions The incidence of skin injury is high among hospitalized SCI patients. A long hospital stay, pressure injury and poor nutrition are independent risk factors for such patients. Such patients should receive skin management education.
万方数据
