压疮概述:病理生理学、流行病学、风险因素、表现和治疗

Bryam Esteban Coello García, Regiane Vita Maximiniano, Jessica Vanessa Sibri Lazo, Marcos Patricio Saguay Cabrera, Karla Lucia Jaramillo Carrasco, Francisco Javier Maldonado Rodríguez, Daniel Esteban Maldonado Barzallo, Gladys Fabiola Zamora Zamora, Cecibel Carolina Mogrovejo Zúñiga, Estefanny Dayana Villafuerte Ruiz
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引用次数: 0

摘要

导言:皮肤改变或病变被称为压疮(PUs),包括局部缺血区域和随后的组织坏死,是由骨突和外表面之间的软组织受到长时间挤压、剪切或摩擦引起的。目的:详细介绍与压疮病理生理学、流行病学、风险因素、表现和治疗相关的最新信息。方法:本综述共分析了 24 篇文章,包括综述文章、原创文章以及临床病例,其中 17 篇参考文献被采用,因为其他文章与本研究无关。信息来源于PubMed、Google Scholar和Cochrane;西班牙文、葡萄牙文和英文的信息搜索关键词为:压疮、皮肤损伤、褥疮:结果:压疮的产生是多因素的。根据世界卫生组织的报告,全球压疮发病率约为 5%至 12%。尽管在过去 20 年里人们越来越重视预防工作,但压疮的发病率几乎没有变化,而相关的护理价值却在不断增加。三分之二的溃疡发生在 70 岁以上的老人身上。结论:由于压疮在全世界的发病率很高,尤其是在 70 岁以上的老人身上,因此应该清楚地了解压疮的识别、表现和病理生理学,以预防压疮的发生。预防措施包括保持和改善组织耐受性以及适当的卸载。必须对内部和外部因素进行评估,因为它们在压疮的形成中起着重要作用。应特别关注流行病学上的高危人群。除了密切监测和相应的伤口管理外,适当的水分补充和充足的营养也是治疗这种疾病的关键。
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OVERVIEW OF PRESSURE ULCERS: PATHOPHYSIOLOGY, EPIDEMIOLOGY, RISK FACTORS, PRESENTATION AND TREATMENT
Introduction: Skin alterations or lesions called pressure ulcers (PUs) encompass localized areas of ischemia with subsequent tissue necrosis, which are generated by prolonged compression, shear or friction of soft tissues between bony prominences and the external surface. Objective: to detail current information related to pressure ulcers pathophysiology, epidemiology, risk factors, presentation and treatment. Methodology: a total of 24 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 17 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: pressure ulcers, skin lesions, decubitus ulcers. Results: The creation of pressure ulcers is multifactorial. The prevalence of pressure ulcers reported globally according to WHO is around 5 to 12%. Despite increased attention to prevention over the last 20 years, the prevalence of pressure ulcers has remained virtually unchanged, yet the related values of care continue to increase. Two-thirds of ulcers occur in people over 70 years of age. Conclusions: due to the high prevalence worldwide, especially in patients over 70 years of age, the recognition, presentation and pathophysiology of pressure ulcers should be clearly understood, with the aim of preventing their occurrence. Prevention consists of maintaining and improving tissue tolerance and adequate offloading. Both internal and external factors have to be evaluated because they play a major role in pressure ulcer formation. Special attention should be paid to epidemiological risk groups. Proper hydration, together with adequate nutrition are essential in the treatment of this condition, in addition to close monitoring and corresponding wound management. Key words: ulcers, pressure, lesions, skin, decubitus.
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