社區(qū)獲得性壓力性損傷現(xiàn)況調(diào)查及對策研究

鄭惠淵 蹇婷婷 張穎 向德兵

[摘要]目的 探討社區(qū)獲得性壓力性損傷發(fā)生的特點(diǎn)，為構(gòu)建合理的防治體系提供依據(jù)。方法 對重慶市江津區(qū)中心醫(yī)院2015年1月～2017年12月入院時有社區(qū)獲得性壓力性損傷的856例患者進(jìn)行調(diào)查，重點(diǎn)調(diào)查年齡、患者來源、發(fā)生部位、分期、Braden評分、疾病種類、病程。結(jié)果 在年齡方面，26～<50歲占7.36%，50～<60歲占6.89%，60～<70歲占17.41%，70～<80歲占32.01%，80～<90歲占30.72%，≥90～105歲占5.61%。在患者來源方面，家庭占72.08%，養(yǎng)老機(jī)構(gòu)占6.31%，其他醫(yī)院占21.61%。在發(fā)生部位方面，頭頸部占0.26%，胸腹部占1.52%，腰背部占6.14%，骶尾部、坐骨結(jié)節(jié)部、髖部占72.92%，陰囊、會陰部占1.25%，四肢占16.78%，其他占1.12%。在分期方面，1期占21.73%，2期占48.75%，3期占14.53%，4期占3.57%，深部組織損傷占4.49%，不能分期占6.94%。在Braden評分方面，6～<10分占20.91%，10～<13分占69.39%，13～<15分占3.50%，15～18分占6.19%。⑥在疾病種類方面，呼吸系統(tǒng)占31.89%，神經(jīng)系統(tǒng)占20.79%，心血管系統(tǒng)占14.72%，運(yùn)動系統(tǒng)占8.76%，內(nèi)分泌系統(tǒng)占7.71%，消化系統(tǒng)占7.01%，免疫系統(tǒng)占5.26%，其他占3.86%。在疾病病程方面，慢性疾病占71.61%，急性疾病占28.39%。結(jié)論 高齡、居家慢性疾病患者是社區(qū)獲得性壓力性損傷的高發(fā)人群。醫(yī)務(wù)人員應(yīng)針對現(xiàn)狀，構(gòu)建合理的防治體系，早期采取有效的防治措施，減少壓力性損傷的發(fā)生，減輕家庭及社會負(fù)擔(dān)。

[關(guān)鍵詞]社區(qū)獲得性壓力性損傷;防治;風(fēng)險管理;對策

[中圖分類號] R195.4? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 1674-4721（2019）7（b）-0151-04

[Abstract] Objective To explore the characteristics of community-acquired stress injuries and to provide the basis for constructing reasonable prevention and treatment system. Methods A total of 856 patients with community-acquired stress injury who were admitted to Center Hospital of Jiangjin District in Chongqing City from January 2015 to December 2017 were investigated. The focus of the survey was age， source of patients， location of occurrence， stage， Braden score， type of disease and course of disease. Results In the aspect of age， patients who were below 50 years old accounted for 7.36%， 50-60 years old accounted for 6.89%， 60-70 years old accounted for 17.41%， 70-80 years old accounted for 32.01%， 80-90 years old accounted for 30.72%， over 90 years old accounted for 5.61%. In the aspect of source of patients， patients from their families accounted for 72.08%， old-age institutions accounted for 6.31%， and other hospitals accounted for 21.61%. In the aspect of occurrence， the proportion of injuries which occurred on head and neck was 0.26%; while that of chest and abdomen was 1.52%; waist and back was 6.14%; sacral tail， sciatic nodules， hip was 72.92%; scrotum， perineum was 1.25%; limbs was 16.78%; others was 1.12%. In the aspect of staging， injuries at stage 1 accounted for 21.73%， stage 2 accounted for 48.75%， stage 3 accounted for 14.53%， stage 4 accounted for 3.57%， deep tissue damages accounted for 4.49%， and injuries which could not be staged accounted for 6.94%. In the aspect of Braden score， 6-<10 points accounted for 20.91%， 10-<13 points accounted for 69.39%， 13-<15 points accounted for 3.50%， and 15-18 points accounted for 6.19%. In the aspect of types of diseases， the proportion of diseases related to respiratory system was 31.89%， while that of nervous system was 20.79%， cardiovascular system was 14.72%， exercise system was 8.76%， internal system was 7.71%， digestive system was 7.01%， immune system was 5.26%， and others was 3.86%. In the aspect of disease course， chronic diseases accounted for 71.61%， sudden illnesses accounted for 28.39%. Conclusion The high risk group of community-acquired stress injury is elderly patients with chronic diseases at home. It is necessary for medical staff to set up a reasonable prevention and treatment system on the basis of current situation. Constructing a reasonable prevention and treatment system in an early stage can effectively cut down the occurrence of stress injuries， reduce economic loss， and lessen family and social burdens.