敷料對使用非侵襲性正壓呼吸器病人顏面壓傷預防之成效

Preventing Facial Pressure Injuries in Patients Who Use Noninvasive Positive Pressure Ventilators: The Efficiency of Dressings

背景：非侵襲性正壓呼吸器（noninvasive positive pressure ventilators, NPPV）為一種不需使用人工氣道進行輔助通氣的呼吸器，而顏面壓傷為其常見的合併症之一。因此如何發展預防策略避免顏面壓傷發生，為照護使用NPPV的病人之重要護理活動。目的：比較泡棉敷料與親水性敷料對使用NPPV病人的顏面壓傷防護之成效。方法　採實驗性研究設計，收集東部某醫學中心內科加護病房使用NPPV的病人，採隨機分派方式，將收案對象分配「泡棉敷料組」及「親水性敷料組」。採自擬式結構式調查表進行每日評估。資料分析使用平均數、標準差、卡方檢定、t檢定及廣義估計方程式。結果　共計收案60位，整體顏面壓傷發生率為11.7%。而「泡棉敷料組」及「親水性敷料組」在NPPV使用時間、壓傷發生率及壓傷發生時間部份皆未達顯著差異。檢視兩組在敷料使用數量上，以「親水性敷料組」多於「泡棉敷料組」達顯著差異。結論　兩種敷料對於使用NPPV病人的顏面壓傷防護無顯著差異。建議臨床上除了常規檢視皮膚之外，可依病人狀況，運用泡棉敷料或親水性敷料來預防顏面壓傷

Background: Noninvasive positive pressure ventilation (NPPV) provides ventilation without tracheal intubation. Facial pressure injury is a recognized complication of this technique, making the prevention of facial pressure injuries an important issue for NPPV patients. Purpose: The present study compared the effects of foam dressing and hydrocolloid dressing in preventing facial pressure injuries in NPPV patients. Method: A randomized clinical trial was used to evaluate participants that were referred from the intensive care unit of a medical center in eastern Taiwan. Participants were randomized into two groups: the foam dressing group and the hydrocolloid dressing group. Statistics used in analysis were: analysis mean, standard deviation, chi-square, independent t-test, and the generalized estimating equation. Results: Sixty participants were enrolled as participants. The incidence rate of facial pressure injury was 11.7% (7/60). No significant difference was found between the two groups in terms of duration of NPPV use, incidence of facial pressure injury, and occurrence time of facial pressure injury. However, the hydrocolloid dressing group had a higher usage amount than the foam dressing group (p ＜ .05). Conclusion: Foam and hydrocolloid dressings are both helpful in preventing facial pressure injury when used in conjunction with regular skin assessments.