红外线测量骶尾部皮肤温度对卧床患者压力性损伤的预测价值分析

Predictive value of infrared measurement of sacrococcygeal skin temperature for stress injury in bedridden patients

  • 摘要:
    目的 分析红外线测量骶尾部皮肤温度对卧床患者压力性损伤(PI)的预测价值。
    方法 将江苏省南通市中医院收治的卧床患者320例纳入研究。所有患者均用红外线测量仪测量骶尾部皮肤温度。采用多因素Logistic回归分析探讨卧床患者PI发生的影响因素。应用受试者工作特征(ROC)曲线分析相关因素预测卧床患者PI发生的价值。
    结果 纳入的320例患者中, 3例治疗过程中转院, 2例在入院48 h内死亡,均按病例脱落处理,其余315例患者中, 43例出现PI的患者纳入PI组, 272例皮肤完好、未出现PI的患者纳入对照组。PI组年龄大于对照组,白蛋白水平、骶尾部皮肤温度和Braden评分低于对照组,差异有统计学意义(P < 0.001)。多因素Logistic回归分析显示,年龄增大是卧床患者PI发生的独立危险因素,白蛋白水平升高、骶尾部皮肤温度升高和Braden评分升高是卧床患者PI发生的保护性因素。ROC曲线显示,各因素联合预测卧床患者发生PI的诊断效能高于年龄、白蛋白、Braden评分和骶尾部皮肤温度,其中骶尾部皮服温度的最佳截点为36.13 ℃, 此时敏感度为93.0%, 特异度为96.3%。压疮分期越高,骶尾部皮肤温度越低。骶尾部温度预测卧床患者1期PI发生的最佳截点为36.33 ℃, 此时敏感度为90.9%, 特异度为60.3%。骶尾部温度预测卧床患者2期和3期PI发生的最佳截点温度为35.92 ℃, 此时敏感度为96.9%, 特异度为91.2%。骶尾部温度预测2期和3期PI发生的敏感度和特异度高于预测1期PI发生的敏感度和特异度。
    结论 入院时应用红外线测量骶尾部皮肤温度可有效预测卧床患者发生PI的风险,有较高诊断价值,且压疮分期越高,预测价值越大。入院监测有助于发现高危患者,提前预防PI的发生。

     

    Abstract:
    Objective To analyze the value of infrared measurement of sacrococcygeal skin temperature in predicting pressure injury (PI) of bedridden patients.
    Methods A total of 320 bedridden patients admitted to Nantong Hospital of Traditional Chinese Medicine were included in the study. The sacrococcygeal skin temperature was monitored by infrared sensor in all patients. Multivariate Logistic regression analysis was used to investigate the influencing factors of PI occurrence in bedridden patients; receiver operating characteristic (ROC) curve was used to analyze the value of correlated factors in predicting the occurrence of PI in bedridden patients.
    Results Among 320 patients included, 3 were transferred to other hospitals during treatment, and 2 died within 48 hours of admission, all of them were shedding cases. Among the remaining 315 patients, 43 patients with PI were included in the PI group, and 272 patients with intact skin and no PI were included in the control group. The age of PI group was higher than that of control group, the albumin level, sacrococcygeal skin temperature and Braden score in the PI group were lower than those in control group (P < 0.001). Multivariate Logistic regression analysis showed that elder age was an independent risk factor for PI in bedridden patients. Increased albumin, increased sacrococcygeal skin temperature and Braden score were protective factors for PI in bedridden patients. ROC curve showed that the diagnostic efficiency of the combination of all factors in predicting the onset of PI in bed patients was higher than that of age, albumin, Braden score and sacrococcygeal skin temperature alone. The optimal cut-off point of sacrococcygeal skin clothing temperature was 36.13℃, and the sensitivity was 93.0% and the specificity was 96.3%. The higher the stage of pressure ulcer was, the lower the skin temperature would be. The best cut-off point of sacrococcygeal temperature for predicting the occurrence of PI in bedridden patients at stage 1 was 36.33 ℃, with a sensitivity of 90.9% and a specificity of 60.3%. The optimal cut-off temperature of sacrococcygeal temperature was 35.92℃ when PI occurred in stage 2 and stage 3 bedridden patients, and the sensitivity and specificity were 96.9% and 91.2% respectively. The sensitivity and specificity of sacrococcygeal temperature in predicting PI occurrence in stage 2 and stage 3 were higher than those in predicting PI occurrence in stage 1.
    Conclusion Infrared measurement of sacrococcygeal skin temperature at admission can effectively predict the risk of PI in bedridden patients, and has high diagnostic value, and the higher the stage of pressure ulcer is, the greater the predictive value will be. Monitoring at admission can help identify high-risk patients and prevent PI in advance.

     

/

返回文章
返回