CN103315889A

CN103315889A - Alternating inflatable mattress for preventing pressure ulcers in medical operation and postoperative convalescence

Info

Publication number: CN103315889A
Application number: CN2013102208512A
Authority: CN
Inventors: 陈芳; 钱艇
Original assignee: Individual
Current assignee: Individual
Priority date: 2013-06-06
Filing date: 2013-06-06
Publication date: 2013-09-25

Abstract

Disclosed is an alternating inflatable mattress for preventing pressure ulcers in a medical operation and postoperative convalescence. According to the alternating inflatable mattress, a position dynamic air mattress is utilized to replace turn-over so as to change skin stressing points to effectively prevent intraoperative pressure ulcers; the alternating inflatable mattress can help paralyzed patients avoid the pressure ulcers and an economic and effective decompression caring device which meets the hospital infection requirements and has a certain industrialization development prospect is provided for the society; a pneumatic device for preventing the pressure ulcers in the medical operation enables reaction, electronic information mechanical interaction and automatic pressure regulation to be performed on the using conditions in the operation in an operation room through a sensor analysis system; the alternating inflatable mattress plays a role in preventing the pressure ulcers in the operation or a few hours to 3 days after the operation and also can be utilized to replace manual turn-over in paralysis physical therapy convalescence.

Description

A kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating

Technical field

The invention belongs to medical apparatus and instruments, Internet of Things applied technical field, the pneumatic shuttle of prevention pressure ulcer in operation, by the biosensor analysis system, make situation about using in operation in control room reaction, electronic information mechanical interaction, automatic Regulation, be applied as the master with the medical industry surgical patient, act in operation or perform the operation and finish to occur in latter several hours to 3 days the prevention of pressure ulcer .

Background technology

Also there is no unified understanding for the prevention that produces pressure ulcer in medical operating at present, pressure ulcer in art produces, because body part is organized long-time pressurized, disturbance of blood circulation, can not suitably supply with skin and subcutaneous tissue desired nutritional, so that local organization is festered and caused by necrosis, the pressure ulcer that in art, pressure ulcer refers to the patient in operation or operation occurs in several hours to 3 days after finishing, in art, pressure ulcer mostly is the pressure ulcer of I phase, show as the pressurized position and erythema occurs in 1-2 days after surgery, color is scarlet, and that presses is colour-fast, often is mistaken as skin scald.

The researchs such as Halfens RJ are thought, the I phase pressure ulcer that can observe immediately after operation can develop rapidly as more serious pressure ulcer, there are some researches show simultaneously, the continuous compression 2h of 70mmHg pressure undertissue is above just can be caused and organize irreversible lesion, operating time is greater than 4 hours, every prolongation can make pressure ulcer occur to increase by 33% in 30 minutes, the researchs such as Molly think that operating time is longer, the probability that pressure ulcer occurs is higher, this is mainly because operating time is longer, the local compression tissue is longer in the time of low perfusion or ischemic state, it is larger that compression zone bit table skin temperature reduces degree, thereby the incidence rate of pressure ulcer is higher.

Once pressure ulcer occurs, not only reduced the patient quality of life, increased the risk that complication occurs, and extended the hospital stays, its treatment has simultaneously also consumed huge medical resource with nursing, there is report U.S. every year to be approximately 1,100,000,000 dollars for the expense of pressure ulcer treating, the medical expense of average every routine Patients with Pressure Ulcers is up to the 500-40000 dollar, increased by 50% nursery work time, there are some researches show, in art, the incidence rate of pressure ulcer is 4%-5%, but wherein 45% can prevent, intermittent pressure relief is the major measure of the long-time pressurized of prevention skin.

In clinical care, the normal method of standing up that adopts solves, be to convert once in 2 hours general interval time, if but the congested reaction of skin observability did not disappear and takes off in 15 minutes, should foreshorten to 1 hour interval time, and when operation is carried out, this is difficult to realize exactly, for this reason, a kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, change skin in compression point in art by replacing inflation/deflation, reach the purpose that reduces the skin in compression time, this device can provide for the generation of avoiding pressure ulcer in art more efficiently prevention to guarantee.

Summary of the invention

A kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, it is the protective equipment of prevention In surgery patient generation pressure ulcer, in operation due to the long-time pressurized of patient body local organization, disturbance of blood circulation, can not suitably supply with skin and subcutaneous tissue desired nutritional, so that local organization is festered and caused by necrosis, the pressure ulcer that in art, pressure ulcer refers to the patient in operation or operation occurs in several hours to 3 days after finishing, there are some researches show that in 23% institute, pressure ulcer is relevant with operation, therefore carrying out the prevention of pressure ulcer in art seems particularly important, reduce pressure ulcer incidence rate in art, improve nursing quality, alleviate the patient suffering.

Pathogeny: because the metabolism of normal skin tissue's cell and division growth depend on the intact of blood vessel and lymphsystem function in subepidermal tissue, when local excessive tissue pressurized, hypodermic vasoganglion will vertically act on because of ambient pressure, while especially over normal terminal vessels, closing pressure (being normally 32mmHg), the tissue fluid circulation is blocked, will cause the local organization ischemia after certain hour, hypoxemia, acidosis, edema and necrosis, blood capillary is closed and pressed is that significant individual variation is arranged, its numerical value and blood vessel structure, the thickness of subcutaneous fat, blood pressure and general health situation are relevant.

Risk factor, patient's oneself factor, age, the danger of reporting that all patient with operation all have pressure ulcer to occur is arranged, in 20-40 years old ages, the pressure ulcer sickness rate can reach 9.3%, the child is postoperative also has pressure ulcer to occur, and the danger that pressure ulcer occurs after during operation in senile patients increases by 2 times, because the increase along with the age, it is poor that epidermis becomes, the skin relatively dry, subcutaneous tissue reduces, Tissue Blood is for reducing, the change of the Physiological factors such as blood capillary is more fragile and insensitive, old people Geng Yi is stressed, the effect of shearing force and frictional force, the risk that pressure ulcer occurs increases, body weight is to cause the mechanics factor that in art, pressure ulcer occurs to comprise pressure at right angle, shearing force and frictional force, wherein pressure at right angle is the topmost factor of pressure ulcer in art, the pressure ulcer pressure is from from heavy sensation of the whole body, weight in patients and skin in compression degree are proportionate, when weight in patients is greater than 75kg, during bed, body weight increases the pressure of skin, easily cause the formation of pressure ulcer, just can cause and organize irreversible lesion more than there are some researches show the continuous compression 2h of 70mmHg pressure undertissue, and patient's skeletonize or when weak, the protection of subcutaneous fat-free mass, pressure ulcer also easily occurs, the disease hypoproteinemia, severe malnutrition, paralysis, cardiovascular disease, diabetes, patient calm and heating is the high-risk group that pressure ulcer occurs, the probability that serum albumin lower than 35g/L person pressure ulcer occurs is 5 times of normal level, add that malnutrition and dehydration are lowered skin elasticity, increased the danger of pressure ulcer, the danger of diabetics generation pressure ulcer is approximately higher 3 times than the ND.

The factor relevant to operation: after wet skin is subject to moist the stimulation, the skin surface faintly acid is destroyed, weaken the protective effect of keratodermatitis, make harmful substance be easy to by, be conducive to bacterial reproduction, humidity is an indispensable project in the risk factors of pressure sore for patients assessment, wet skin is higher 5 times than dry skin generation pressure ulcer probability, and patient with operation is due to disinfectant solution, the reasons such as flushing liquor, inevitably can make skin be pasted on for a long time moist operating-table, on bed surface, thereby cause the pressure ulcer odds to increase, Anesthetic factor: due to the impact of anaesthetic, there is 55% patient that hypoxemia occurs during surgery anesthesia, and due to the retardation of anaesthetic, make the vasodilation that is subject to site of block following, blood flow is slack-off, the pressurized position loses normal blood circulation, anesthetis and the vasoactive agent in art, applied have a significant effect to blood pressure, beta-blocker can make tissue blood flow reduce 20%-30%, may increase the danger of pressure ulcer, and the patient of general anesthesia, effect due to medicine, whole-body muscle is lax, the patient is in complete passive state, after muscle and blood vessel lose innervation, systolic and diastolic function is lost, local organization circulatory disturbance, increase the weight of the skin histology anoxia, the mass exchange obstacle causes a lot of anaerobic metabolism products not drain in time, easily form pressure ulcer, feel that it is the main cause of patient with general anesthesia generation pressure ulcer that impaired and degree of excursion descends.

Operation position: have research to think, various operation position patients' pressure ulcer incidence rate difference not statistically significant, the incidence rate of supine position pressure sore is compared the difference not statistically significant with lateral position, no matter be which kind of position, brake request due to operation, patient with operation must maintain long-time fixed operation clinostatism, some bone bulge regions particularly, always in the continuous compression state, very easily form pressure ulcer, in art for preventing patient's hypothermia, often can adopt various warming measures, as spread insulation blanket etc., and 1 ℃ of the every rising of body temperature, tissue metabolism's oxygen demand increases by 10%, when organizing continuous compression to produce ischemia, merge the hypermetabolism demand that fervescence causes, can increase the danger of pressure ulcer, when contrary body temperature is low, body is closed peripheral circulation, pressurized zone blood is for reducing, also reach and easily cause pressure ulcer to form, the operating room low temperature environment, the surgical exposure time is long, a large amount of input freezer blood, the reasons such as anesthesia muscular flaccidity body heat production minimizing all can cause patient temperature low, thereby increase the probability that pressure ulcer occurs, the pressure ulcer incidence rate of patient with operation increases along with the prolongation of operating time, it 2.5 hours is the risk factor that pressure ulcer occurs that operating time surpasses, operating time surpasses in the patient of 4 hours, the longer postoperative pressure ulcer incidence rate of operating time is 21.2%, the local compression tissue is longer in the time of low perfusion or ischemic state, it is larger that compression zone bit table skin temperature reduces degree, the pressure ulcer incidence rate is higher, in art the hypotension time length may cause the perfused tissue deficiency, can reduce tissue to ischemia, the tolerance of anoxia, to form the risk factor that in art, pressure ulcer occurs, the risk factor that pressure ulcer occurs after the operation in patients of hypotension time and operating time ratio>20% in art is not occur 5.5 times of hypotensive in art, after operation finishes, ischemical reperfusion injury easily occurs in the pressurized position, predilection site: in art, the pressure ulcer predilection site is relevant with operation position, dorsal position is more common in sacrum section and heel, ventricumbent position is sternal part and chin section, the side-lying position operation pressure ulcer is apt to occur in ear, acromion, ancon, hip, the kneed interior outside, medial and lateral malleolus, postoperative pressure ulcer 85% betides sacrococcygeal region, in order to prevent above-mentioned phenomenon, the method and system setting of prevention pressure ulcer in this operation, can avoid postoperative pressure ulcer to produce.

the technical scheme of taking is:

A kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, use risk factors of pressure sore for patients assessment scale, help nursery work person effectively to find out in those highly dangerous in pressure ulcer occurs, the patient that need to process in time and take measures, with Concha Arcae air pressure mattress (1), aerating pipe (2), air valve (3), sensor (4), the display panel of controller (touch screen) (5), alarm device (6), can start Concha Arcae air pressure mattress switch (7), cabling cabinet (8), intelligent analysis system (9), roller (10), in the input information intelligent analysis system (9) of perception scale, realize that by display video data on display screen of controller the thing connection is interactive, pass through sensor (4) trigger alarm device (6) after reaching setting value, automatically start Concha Arcae air pressure mattress (1).

Alternative inflatable cushion adopts the gas cell in six electric pneumatic hemostatic sleeve belts to make a square air cushion (55*40cm), by odevity respectively with the threeway of valve and be unified into two supervisors, last and be unified into a house steward and be connected on intelligent analysis system (9) through cabling cabinet (8), medical personnel can observe patient's abnormal response and fault is set by monitoring alarm device (6), the conversion automatic programme control is manual control rapidly, can start Concha Arcae air pressure mattress switch (7), open air valve (3), by aerating pipe (2), to Concha Arcae air pressure mattress (1), alternately inflate, realized the prevention that postoperative pressure ulcer produces and avoided, reduced medical and nursing work person's working strength.

Pressure ulcer prophylaxis measure in art: rationally settle position, because heel portion and sacrococcygeal region are the positions that human body bears the pressure maximum, so will note the reasonable placement at these positions when placing position, can place medium thin gel mat at these two positions, when special posture is put, the doctor, the nurse places together with anesthesia, during patient carrying, avoid pushing away, drag, the action such as draw, settling operation position is the specificity requirement of patient with operation, dragging when settling position, draw, push away and easily cause mattress to fold or the sheet out-of-flatness, the use of localizer can be oppressed bone prominence skin, when traction apparatus can be oppressed the interior tissue horizontal position, should first the patient be lifted to translation more slightly, the natural physiological bending degree that as far as possible keeps the patient, forbid that health is unsettled, limbs are tractive excessively, prevent nerve injury, sheet keeps dry, smooth, the row gauffer, the pressurized position, Ji Gu prominence, restraining belt position skin should be thickeied the posture pad protection, localizer and traction apparatus not directly act on patient skin, to rationally use liner, guarantee impetus in the situation that increase contact area and improve sark and supporter by Pressure Drop to minimum, reduce the generation of pressure ulcer.

The method and system setting of prevention pressure ulcer in operation, use the pressure regulating equipment of decompression care appliances pressure ulcer comprise that static state setting is standby and dynamically arrange, static state setting comprises foam, water, gel, air mattress, dynamically arrange and comprise alternative pressure equipment, can automatically redistribute the pressure at pressurized position, and the specificity that in art, pressure regulating equipment is braked due to operation requires to seem comparatively narrow, mostly be static device, clinical posture pad is main mainly with foam-rubber cushion, but traditional sponge pad permeability is not good, and the long period is used the local depression that easily forms of rear foam rubber cushion, cause patient's local skin humidity and organize congestion, cause the generation of pressure ulcer.

Adopt 3L transfusion bag transformation of the way posture pad, after water-filling, plasticity is strong, it is comfortable that the patient feels, can alleviate the pressure of local organization, and low price is practical, compare the Auckland posture pad formed by the macromolecule polyurethane elastomer, though good flexibility and resistance to compression shock-absorbing function are arranged, the different position supports and the protection that give the patient are stablized comfortable, dispersive pressure to greatest extent, reduce, avoid pressure ulcer formation and nerve injury, but the shortcoming of this posture pad is selling at exorbitant prices, should not popularize, and sterilization method is limited fragile, other gel mattress is also little to reducing the interfacial pressure effect, once applied the active viscoelastic foam pad of temperature that 4cm is thick abroad, the pressure that disperses preferably parts of body, reduce the incidence rate of pressure ulcer.

Aforementioned a kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, it is characterized in that: when performing the operation over 1 hour, under the prerequisite that does not affect operation technique, by replacing inflation/deflation vibration pressurized position, decompressing effect is arranged, to alleviate local compression, increase patient's comfort, promote local blood circulation.

beneficial effect is:

A kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, in art, the prevention of pressure ulcer replaces standing up with position dynamic air mattress, obtained the effect of easing stress reached, with the integrated gas equalizing bed, to compare price low, easy maintenance is simple and easy, good stability is arranged, do not affect the accurate operation in operation, easily universal, the electronic information programming is simple, accurately interactive with mechanical electric apparatus, by alternative inflatable cushion, replace the method for standing up to change the skin stress point, thereby effectively prevent pressure ulcer in art, the type alternative inflatable cushion can help the paralytic to avoid pressure ulcer to produce, for society provides a kind of more economical, effectively, meet the hospital infection requirement, and the decompression care appliances with certain Developmental Prospect of Industrialization provides clinical foundation.

Fig. 1 is the alternative inflatable cushion system schematic, and Fig. 2 is the intelligent analysis system installation drawing, and Fig. 3 is front view.

Below in conjunction with accompanying drawing, the invention will be further described:

As shown in Figure 1, a kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, by Braden scale analysis patient condition, the prevention grade, in the input information intelligent analysis system (9) of perception scale, be delivered to monitoring alarm device (6) by sensor (4) signal, the upper video data of the display panel of controller (5), automatically start Concha Arcae air pressure mattress (1) after reaching setting value, also can observe patient's abnormal response and fault is set by monitoring alarm device (6) by medical personnel, the conversion automatic programme control is manual control rapidly, can start Concha Arcae air pressure mattress switch (7), open air valve (3), by aerating pipe (2), to Concha Arcae air pressure mattress (1), alternately inflate.

Change system into posture pad by the 3L transfusion bag, after water-filling, plasticity is strong, it is comfortable that the patient feels, can alleviate the pressure of local organization, and low price is practical, designed, designed alternative inflatable cushion: adopt six gas cells in the electric pneumatic hemostatic sleeve belt to make a square air cushion (55*40cm), by odevity respectively with the threeway of valve and be unified into two supervisors, last and be unified into a house steward and be connected on intelligent analysis system through the cabling cabinet, preoperatively will make the sacrococcygeal region that alternative inflatable cushion is positioned over patient's pressurized by oneself, give airbag aeration to 6Kpa regularly 60 minutes with orthopaedics with the electric pneumatic hemostatic apparatus, after the instrument warning, the thing connection is interactive, close after the three-way valve of even mark inflation again regularly 60 minutes, then be to inflate after closing the three-way valve of odd mark, same regularly 60 minutes, alternate repetition like this, single in one cotton of pre-operative surgical bed upper berth, and change system into posture pad with transfusion bag on the sacrococcygeal region pad, lower is Braden scale grade form:

The design is a kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, application criterion: I phase bedsore evaluation standard, skin complete but the erythema of fading of pressure is arranged, this erythema shows the hyperemia of responding property of skin, reactive hyperemia should be removed in 24 hours and disappear at pressure, if continuous compression, what erythema was pressed is colour-fast, finally occur that ischemic is pale, this initial performance that is the organizational structure irreversible lesion.

After operation finishes, send patient to observe sacrococcygeal region skin timely record before chamber, within postoperative 1 day, pay a return visit to ward, again observe sacrococcygeal region skin conditions record, skin normally is called normally, erythrosis but pressure remove after in 30min color restoration be normally reactive hyperemia, be called and redden; If after 30min, skin still takes on a red color, or occur that blister or breakage are called pressurized.

Above demonstration and described a kind of in medical operating and the alternative inflatable cushion of stage of rehabilitation prevention pressure ulcer, principal character and advantage, the technical staff of the industry should understand, this novel alternative inflatable cushion is not restricted to the described embodiments, that in above-described embodiment and description, describes just illustrates present principles, under the prerequisite that does not break away from the presents spirit and scope, the design also has various changes and modifications, these changes and improvements all fall in claimed scope, a kind of alternative inflatable cushion that reaches stage of rehabilitation prevention pressure ulcer in medical operating, claimed scope is by appending claims and equivalent circle thereof.

Claims

1. one kind reaches the alternative inflatable cushion that stage of rehabilitation prevents pressure ulcer in medical operating, it is characterized in that: the display panel (touch screen) (5) of Concha Arcae air pressure mattress (1), aerating pipe (2), air valve (3), sensor (4), controller, alarm device (6), can start Concha Arcae air pressure mattress switch (7), cabling cabinet (8), intelligent analysis system (9), roller (10).

2. according to claim 1 a kind of in medical operating and the alternative inflatable cushion of stage of rehabilitation prevention pressure ulcer, it is characterized in that: Concha Arcae air pressure mattress (1), aerating pipe (2), air valve (3), sensor (4), the display panel of controller (touch screen) (5), alarm device (6), can start Concha Arcae air pressure mattress switch (7), cabling cabinet (8), intelligent analysis system (9), roller (10), in the input information intelligent analysis system (9) of perception scale, realize that by display video data on display screen of controller the thing connection is interactive, pass through sensor (4) trigger alarm device (6) after reaching setting value, automatically start Concha Arcae air pressure mattress (1).

3. according to claim 1 a kind of in medical operating and the alternative inflatable cushion of stage of rehabilitation prevention pressure ulcer, it is characterized in that: by the scale analysis patient condition, the prevention grade, in the input information intelligent analysis system (9) of perception scale, be delivered to monitoring alarm device (6) by sensor (4) signal, the upper video data of the display panel of controller (5), automatically start Concha Arcae air pressure mattress (1) after reaching setting value, also can observe patient's abnormal response and fault is set by monitoring alarm device (6) by medical personnel, the conversion automatic programme control is manual control rapidly, can start Concha Arcae air pressure mattress switch (7), open air valve (3), by aerating pipe (2), to Concha Arcae air cushion bed pad air cushion (1), alternately inflate.

4. according to claim 3 a kind of in medical operating and the alternative inflatable cushion of stage of rehabilitation prevention pressure ulcer, it is characterized in that: alternative inflatable cushion adopts the gas cell in six electric pneumatic hemostatic sleeve belts to make a square air cushion (55 * 40cm), by odevity respectively with the threeway of valve and be unified into two supervisors, last and be unified into a house steward and be connected on intelligent analysis system (9) through cabling cabinet (8), medical personnel can observe patient's abnormal response and fault is set by monitoring alarm device (6), the conversion automatic programme control is manual control rapidly, can start Concha Arcae air pressure mattress switch (7), open air valve (3), by aerating pipe (2), to Concha Arcae air pressure mattress (1), alternately inflate.