个体化体位护理对ICU长期卧床患者压力性损伤的预防效果

Preventive Effect of Individualized Positioning Care on Pressure Injuries in Long-Term Bedridden ICU Patients

摘要: 目的：探讨个体化体位护理对ICU长期卧床患者压力性损伤的预防效果，为优化危重症患者体位管理方案提供参考。方法：选取某三级甲等医院ICU收治的100例长期卧床患者作为研究对象，按照随机数字表法分为对照组和观察组，每组50例。对照组实施常规体位护理，观察组在常规护理基础上实施个体化体位护理。比较两组压力性损伤发生率、发生时间及严重程度，分析护理前后Braden评分、皮肤潮湿程度、受压部位皮肤状况、体位护理执行情况与护理满意度。采用SPSS 27.0软件进行数据处理，计量资料采用独立样本t检验和配对样本t检验，计数资料采用χ²检验。结果：观察组压力性损伤发生率为4.00%，低于对照组的18.00%，差异具有统计学意义(P < 0.05)。护理7 d和护理14 d后，观察组Braden评分均高于对照组，皮肤潮湿评分和局部皮肤异常发生率均低于对照组(P < 0.05)。观察组体位护理执行率、减压用具规范使用率、皮肤评估完成率及护理满意度均高于对照组(P < 0.05)。结论：个体化体位护理能够根据ICU长期卧床患者的病情、压力性损伤风险、受压部位和耐受程度动态调整体位方案，有助于减少局部持续受压和剪切力，改善皮肤状况，降低压力性损伤发生风险，具有较好的临床应用价值。

Abstract: Objective: To investigate the preventive effect of individualized positioning care on pressure injuries in long-term bedridden patients in the intensive care unit (ICU), thereby providing a reference for optimizing positioning management among critically ill patients. Methods: A total of 100 long-term bedridden patients admitted to the ICU of a tertiary hospital were selected and divided into a control group and an observation group using a random number table, with 50 patients in each group. The control group received routine positioning care, while the observation group received individualized positioning care in addition to routine care. The incidence, onset time, and severity of pressure injuries were compared between the two groups. Braden Scale scores, skin moisture status, skin conditions at pressure-prone sites, implementation of positioning care, and nursing satisfaction before and after the intervention were also analyzed. SPSS 27.0 was used for statistical analysis. Measurement data were analyzed using independent-samples t-tests and paired-samples t-tests, while categorical data were analyzed using the chi-square test. Results: The incidence of pressure injuries in the observation group was 4.00%, which was significantly lower than the 18.00% recorded in the control group (P < 0.05). At 7 and 14 days after the intervention, the Braden Scale scores of the observation group were significantly higher than those of the control group, while the skin moisture scores and incidence of local skin abnormalities were significantly lower (P < 0.05). The observation group also demonstrated significantly higher rates of positioning-care implementation, standardized use of pressure-relieving devices, completion of skin assessments, and nursing satisfaction than the control group (P < 0.05). Conclusion: Individualized positioning care enables dynamic adjustment of positioning plans according to the clinical condition, pressure-injury risk, pressure-prone sites, and tolerance of long-term bedridden ICU patients. This approach can reduce prolonged localized pressure and shear forces, improve skin conditions, and decrease the risk of pressure injuries, demonstrating considerable value for clinical application.