Risk Factors For Acute Pressure Sores In Patients Undergoing Posterior Spinal Surgery And Countermeasures

ObjectiveTo explore the risk factors for acute pressure ulcers in patients undergoing posterior spinal surgery during the operation.Formulating corresponding nursing countermeasures accorded to the results of risk factors analysisMethods200 patients who underwent posterior spinal surgery in our hospital from January 2017 to January 2018 were selected as the subjects of the risk factors for pressure sore.The basic data and related indicators before operation were collected:age,sex,weight,height,operation history,history of pressure ulcer,vital signs,fasting time and hospitalization days.The serum hemoglobin,albumin,total protein level,blood glucose level,blood cell count,lymphocyte count and white blood cell count of patients were the final biochemical examination results in patients' medical records.The related indicators in the study were collected:operation room humidity and temperature,blood loss during operation,blood oxygen saturation,vital signs,operative time,anaesthesia score and hypotension time.The related indexes after the operation were collected:the temperature after operation and the time of fasting after the operation.Results(1)There were 21 cases of pressure ulcers,and 13 of the subjects had stage ?pressure sore on the day after the operation,and the other 8 patients had stage ? pressure sore within first to sixth days after the operation.Of the 21 patients with stage ? pressure sore in 6 days after operation,4 cases of pressure sore were changed to stage ?.21 cases of pressure sores in the compressed area included 5 cases of cheeks,8 cases of forehead,6 cases of iliac crest,3 cases of shoulders,5 cases of ribs,and 3 cases of pressure sore.(2)Different gender,preoperative hospitalization days,preoperative fasting time,different hemoglobin level of pressure ulcer is no significant difference between the rate(P>0.05);different age,body mass index,smoking history,diabetes,have no pressure ulcer history,serum albumin level and total protein level,different the serum glucose levels of pressure ulcer had significant difference between the rate(P<0.05).(3)The American Society of Anesthesiologists score of different grade,different temperature and different,whether there is blood loss in pressure ulcer is no significant difference between the rate of intraoperative hypotension(P>0.05);the duration and different duration of anesthesia of different operation pressure sores occurred there was significant difference between the rate(P<0.05).(4)There was no significant difference in the incidence of post-operative fasting time,postoperative analgesia,or whether the body temperature was normal within 3 days after the operation(P>0.05).(5)Diabetes,age,serum albumin level and duration of anesthesia are the risk factors of acute pressure ulcer patients in posterior spinal surgery operation period,the history of diabetes mellitus and duration of anesthesia are the risk factors of acute pressure ulcer patients in posterior spinal surgery operation period(OR =>1),serum albumin level and age is a protective factor for the occurrence of acute pressure ulcer the posterior spinal surgery period(OR =<1).Conclusions(1)Posterior spinal surgery operation period in patients with acute pressure ulcer incidence rate is 10.5%,the incidence of pressure ulcers are part of the cheek,denomination,iliac crest,shoulder,costal margin and anterior tibial bone or muscle bulge region of adipose tissue contains fewer parts,most of the pressure ulcer in the postoperative day.(2)Age,body mass index,smoking history,diabetes,pressure ulcer history,serum albumin level,serum total protein level,blood sugar level,duration of operation and duration of anesthesia are related to acute pressure ulcers in patients undergoing posterior spinal surgery.(3)According to the patient's age,body mass index,smoking history,diabetes,pressure ulcer history,the levels of serum albumin and total serum protein level,blood glucose level,duration of operation and duration of anesthesia nursing strategies,improve the quality of care,to prevent and reduce the spinal surgery after operation period in patients with acute pressure ulcer incidence is important guide.