重症监护室患者压力性损伤的危险因素及Braden评分和经皮氧分压的预测价值分析

摘要 目的：分析重症监护室（ICU）患者压力性损伤（PI）的危险因素并探讨Braden评分和经皮氧分压（TcPO₂）对其的预测价值。方法：选取2019年12月～2021年12月我院ICU 45例发生PI患者为PI组，另选取ICU 45例未发生PI患者为非PI组，收集患者基线资料、Braden评分及TcPO₂。比较两组患者基线资料和Braden评分、TcPO₂，采用多因素Logistic回归模型分析ICU患者发生PI的危险因素，绘制受试者工作特征（ROC）曲线分析Braden评分与TcPO₂对ICU患者PI发生风险的预测价值。结果：PI组年龄大于非PI组，机械通气比例和体温高于非PI组，住院时间长于非PI组，血清白蛋白、Braden评分、TcPO₂低于非PI组（P＜0.05）。多因素Logistic回归分析显示，年龄增长（OR=1.100，95％CI：1.003～1.206）、体温上升（OR＝1.217，95％CI：1.014～1.460）、住院时间延长（OR=1.240，95％CI：1.049～1.467）、Braden评分下降（OR=1.950，95％CI：1.312～2.898）、TcPO₂下降（OR=1.128，95％CI：1.053～1.209）为ICU患者发生PI的危险因素（P＜0.05）。ROC曲线分析显示，Braden评分和TcPO₂单独与联合预测ICU患者PI发生风险的曲线下面积（AUC）分别为0.785、0.794、0.898，Braden评分联合TcPO₂预测ICU患者PI发生风险的AUC大于二者单独预测。结论：年龄增长、体温上升、住院时间延长、Braden评分下降、TcPO₂下降是ICU患者发生PI的危险因素，Braden评分、TcPO₂对ICU患者PI发生风险具有一定的预测价值，二者联合效能更佳。

Risk Factors for Pressure Injury in Intensive Care Unit Patients and the Predictive Value Analysis of Braden Score and Transcutaneous Oxygen Pressure

ABSTRACT Objective: To analyze the risk factors for pressure injury (PI) in intensive care unit (ICU) patients and to explore the predictive value of Braden score and transcutaneous oxygen pressure (TcPO₂). Methods: From December 2019 to December 2021, 45 patients with PI in ICU of our hospital were selected as PI group, and 45 patients without PI in ICU were selected as non PI group. Baseline data, Braden score and TcPO₂ of patients were collected. The baseline data, Braden score and TcPO₂ of the two groups were compared. The risk factors of PI in ICU patients were analyzed by multivariate Logistic regression model, and the receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of Braden score and TcPO₂ on the risk of PI in ICU patients. Results: The age of PI group was older than that of non PI group, the proportion of mechanical ventilation and body temperature were higher than those of non PI group, the length of hospital stay was longer than that of non PI group, and the serum albumin, Braden score and TcPO₂ were lower than those of non PI group (P<0.05). Multivariate Logistic regression analysis showed that increasing age (OR=1.100, 95% CI: 1.003~1.206), rising body temperature(OR=1.217, 95% CI: 1.014~1.460), prolonged hospital stay (OR=1.240, 95% CI: 1.049~1.467), decreased Braden score (OR=1.950, 95% CI: 1.312~2.898) and decreased TcPO2(OR=1.128, 95% CI: 1.053~1.209) were the risk factors for PI in ICU patients (P<0.05). ROC curve analysis showed that the area under the curve(AUC) of Braden score and TcPO₂ alone and in combination were 0.785, 0.794 and 0.898, respectively, and the AUC of Braden score and TcPO₂ alone in predicting the risk of PI in ICU patients was greater than that of the two alone. Conclusion: Increasing age, rising body temperature, prolonging hospital stay, decreasing Braden score and decreasing TcPO₂ are the risk factors of PI in ICU patients. Braden score and TcPO₂ have certain predictive value for the risk of PI in ICU patients, and the combination efficiency of the two is better.