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Article(id=1322929629257937240, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929547464815391, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.14.007, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1739808000000, receivedDateStr=2025-02-18, revisedDate=1781452800000, revisedDateStr=2026-06-15, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340602459, onlineDateStr=2026-10-30, pubDate=1784908800000, pubDateStr=2026-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340602459, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340602459, creator=13701087609, updateTime=1793340602459, updator=13701087609, issue=Issue{id=1322929547464815391, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='14', pageStart='2385', pageEnd='2576', issueExtLink='null', onlineDate='null', pubDate='1784908800000', pubDateStr='2026-07-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793340582958, creator='13701087609', updateTime=1793343111003, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940150912790807, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929547464815391, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940150912790808, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929547464815391, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2437, endPage=2443, ext={EN=ArticleExt(id=1322929629501206873, articleId=1322929629257937240, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Pressure injury incidence and influencing factors in elderly patients with different activity levels: a multicenter study, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the pressure injury incidence and influencing factors in elderly patients with different activity levels.

Methods

A multicenter cross-sectional survey was conducted,enrolling elderly patients aged≥65 years from eight tertiary hospitals. Data on general information,health status,skin examination,and implementation of preventive measures were collected using uniformly trained research tools and methods.

Results

A total of 4 851 elderly patients were included,of whom 107 developed pressure injuries,resulting in an incidence rate of 2.2%.Among the independently mobile group,7(0.2%) developed pressure injuries.Among the crutches/assistance/wheelchairs group,16(1.9%) developed pressure injuries.Among the bedridden group,84(7.9%) developed pressure injuries.In the independently mobile group,age,dietary status,and type of dressing at pressure sites were independent risk factors for pressure injuries.In the crutches/assistance/wheelchair group,the Braden score was an independent risk factor.In the bedridden group,education level,Braden score and type of dressing at pressure sites were independent risk factors.

Conclusions

The incidence of pressure injuries in elderly patients is closely related to their activity levels,with lower activity levels associated with higher incidence rates.Risk factors for pressure injuries vary among patients with different activity levels.Targeted stratified prevention strategies should be implemented for independently mobile,crutches/assistance/wheelchair,and bedridden patients,focusing on key factors such as advanced age,nutrition,Braden score,medication use,and local dressing applications to effectively reduce the risk of pressure injuries.

, authors=Yaling WANG1, Xiaolian DENG1, Li YANG1, Jing DU2, Juan DU1, Yanmei ZHANG1, Baosong LI1, Teng WANG1, Qin LIU1, Chengcheng HUANG1, Qixia JIANG2, authorsList=Yaling WANG, Xiaolian DENG, Li YANG, Jing DU, Juan DU, Yanmei ZHANG, Baosong LI, Teng WANG, Qin LIU, Chengcheng HUANG, Qixia JIANG, authorCompany=null, correspAuthors=Qixia JIANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322929630063243610, articleId=1322929629257937240, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=不同活动力老年病人压力性损伤发生率及其影响因素：一项多中心研究, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

探究不同活动力老年病人压力性损伤发生率及其影响因素。

方法

采取多中心横断面调查的方法，收集8所三级甲等医院的年龄≥65岁老年病人，按照统一培训的调研工具及方法收集纳入对象的一般资料、健康状况、皮肤检查资料和预防措施落实资料等。

结果

共纳入老年病人4 851例，发生压力性损伤107例，发生率为2.2%；独立活动组发生压力性损伤的老年人7例（0.2%），拄拐/搀扶/轮椅组16例（1.9%），卧床组84例（7.9%）。在独立活动组中，年龄、饮食情况、受压处的敷料类型为老年人压力性损伤的独立危险因素；在拄拐/搀扶/轮椅组中，Braden评分为老年人压力性损伤的独立危险因素；在卧床组中，学历、Braden评分、受压处敷料类型为老年人压力性损伤的独立危险因素。

结论

老年病人压力性损伤的发生率与其活动能力密切相关，活动能力越差，发生率越高。不同活动能力病人压力性损伤的危险因素存在差异，应针对独立活动、拄拐/搀扶/轮椅及卧床病人采取针对性的分层预防策略，重点关注高龄、营养、Braden评分、用药及局部敷料使用等关键因素，以有效降低压力性损伤的发生风险。

, authors=王亚玲1, 邓小炼1, 杨力1, 杜静2, 杜娟1, 张燕梅1, 李保松1, 王滕1, 刘琴1, 黄程程1, 蒋琪霞2, *, *, authorsList=王亚玲, 邓小炼, 杨力, 杜静, 杜娟, 张燕梅, 李保松, 王滕, 刘琴, 黄程程, 蒋琪霞, authorCompany=null, correspAuthors=蒋琪霞, authorNote=

王亚玲，主任护师，博士研究生

, correspAuthorsNote=
蒋琪霞，E-mail：
JIANG Qixia, E-mail:
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unstructuredReference=Shin W,Weatherbee M,Rehan Z,et al.Malnutrition in older adults with chronic wounds:a prospective cohort study[J].Adv Skin Wound Care,2026,25., articleTitle=Malnutrition in older adults with chronic wounds:a prospective cohort study, refAbstract=null), Reference(id=1322929642461606345, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, doi=null, pmid=null, pmcid=null, year=2022, volume=35, issue=3, pageStart=156, pageEnd=165, url=null, language=null, rfNumber=31, rfOrder=30, authorNames=Munoz N, journalName=Adv Skin Wound Care, refType=null, unstructuredReference=Munoz N.Malnutrition and pressure injury risk in vulnerable populations:application of the 2019 international clinical practice guideline[J].Adv Skin Wound Care,2022,35(3):156-165., articleTitle=Malnutrition and pressure injury risk in vulnerable populations:application of the 2019 international clinical practice guideline, refAbstract=null), Reference(id=1322929642541298122, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, doi=null, pmid=null, pmcid=null, year=2022, volume=31, issue=12, pageStart=S26, pageEnd=s30, url=null, language=null, rfNumber=32, rfOrder=31, authorNames=Manley S, Mitchell A, journalName=Br J Nurs, refType=null, unstructuredReference=Manley S,Mitchell A.The impact of nutrition on pressure ulcer healing[J].Br J Nurs,2022,31(12):S26-s30., articleTitle=The impact of nutrition on pressure ulcer healing, refAbstract=null), Reference(id=1322929642637767115, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, doi=null, pmid=null, pmcid=null, year=2022, volume=31, issue=4, pageStart=322, pageEnd=328, url=null, language=null, rfNumber=33, rfOrder=32, authorNames=Monaco D, journalName=J Wound Care, refType=null, unstructuredReference=Monaco D.Effect of a wound healing protocol on patients with stage Ⅲ and Ⅳ pressure ulcers:a preliminary observational study[J].J Wound Care,2022,31(4):322-328., articleTitle=Effect of a wound healing protocol on patients with stage Ⅲ and Ⅳ pressure ulcers:a preliminary observational study, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322929630327484763, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, xref=1, ext=[AuthorCompanyExt(id=1322929630335873372, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, companyId=1322929630327484763, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Army Characteristic Medical Center, Chongqing 404000 China), AuthorCompanyExt(id=1322929630344261981, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, companyId=1322929630327484763, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1陆军特色医学中心，重庆 404000)]), AuthorCompany(id=1322929631963263326, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, xref=2, ext=[AuthorCompanyExt(id=1322929631971651935, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, companyId=1322929631963263326, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Eastern Theater General Hospital), AuthorCompanyExt(id=1322929631980040544, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, companyId=1322929631963263326, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2东部战区总医院)])], figs=[ArticleFig(id=1322929637935952295, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, language=EN, label=Table 1, caption=

Univariate analysis of factors associated with pressure injuries in elderly patients with different activity levels

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类独立活动（n=2 928）拄拐/搀扶/轮椅（n=862）卧床（n=1 061）
发生组（n=7）未发生组（n=2 921）P发生组（n=16）未发生组（n=846）P发生组（n=84）未发生组（n=977）P
性别[例（%）]男5（5/7）1 841（63.0）0.9468（50.0）537（63.5）0.26857（67.9）599（61.3）0.236
女2（2/7）1 080（37.0）8（50.0）309（36.5）27（32.1）378（38.7）
年龄（岁）82.0（73.0，86.0）71.0(68.0,76.0)0.02583.0（71.0，94.3）76.0（70.0，87.0）0.09679.5（72.0，92.0）75.0（69.0，88.0）0.016
学历[例（%）]文盲/小学3（3/7）1 325（45.4）0.8328（50.0）322（38.1）0.83225（29.8）360（36.8）0.009
初中2（2/7）878（30.1）2（12.5）214（25.3）13（15.5）251（25.7）
高中2（2/7）456（15.6）2（12.5）145（17.1）19（22.6）179（18.3）
专科及以上0（0/7）262（8.9）4（25.0）165（19.5）27（32.1）187（19.2）
主要照护者[例（%）]自护/家人5(5/7)2 781(95.2)11（68.7）631（74.6）0.63628（33.3）492（50.4）<0.001
护工/保姆2(2/7)128(4.4)0.0635（31.3）205（24.3）26（31.0）314（32.1）
护士0（0/7）12(0.4)0（0.0）10（1.1）30（35.7）171（17.5）
本次入住时长（d）12.0（4.0，16.0）5.0（3.0，9.0）0.05512.5（7.0，33.0）8.0（4.0，16.0）0.13114.0（7.0，30.5）9.0（5.0，20.0）<0.001
Braden评分(分)15.0（7.0，16.0）17.0（16.0，18.0）0.00912.0（10.0，13.0）15.0（12.0，16.0）0.0016.0（4.0，8.8）10.0（8.0，13.0）<0.001
营养途径[例（%）]经口7（7/7）2 841(97.3)1.00014（87.5）749（88.6）1.00023（27.4）562（57.5）<0.001
鼻饲/管饲0（0/7）42(1.4)2（12.5）61（7.2）55（65.5）347（35.5）
肠外0（0/7）0（0.0）0（0.0）19（2.2）0（0.0）40（4.1）
经皮胃造瘘技术/其他0（0/7）38(1.3)0（0.0）17（2.0）6（7.1）28（2.9）
每日饮水量1 500 mL[例（%）]是3(3/7)1 944(66.6)0.3557（43.7）427（50.5）0.59433（39.3）455（46.6）0.199
否4(4/7)977(33.4)9（56.3）419（49.5）51（60.7）522（53.4）
近1周排便情况[例（%）]失禁0（0/7）6（0.2）1.0001（6.3）21（2.5）0.34135（41.7）180（18.4）<0.001
自控/肠造口7（7/7）2 915（99.8）15（93.7）825（97.5）49（58.3）797（94.4）
近1周排尿情况[例（%）]失禁0（0/7）9（0.3）1.0001（6.3）27（3.2）0.17616（19.0）133（13.6）<0.001
自控7（7/7）2 839（97.2）13（81.3）778（92.0）20（23.9）504（51.6）
留置尿管/膀胱造瘘0（0/7）73（2.5）2（12.4）41（4.8）48（57.1）340（34.8）
失禁相关性皮炎[例（%）]是0（0/7）0（0.0）1.0000（0.0）1（0.1）1.00010（11.9）35（3.6）<0.001
否7（7/7）2 921（100.0）16（100.0）845（99.9）74（88.1）942（96.4）
饮食情况[例（%）]禁食禁水0（0/7）32（1.1）0.0050（0.0）13（1.5）0.4877（8.3）40（4.1）0.265
每日3餐均衡饮食3（3/7）2 427（83.1）7（43.8）493（58.3）43（51.2）507（51.9）
每日3餐，每餐>1/21（1/7）339（11.6）6（37.5）245（29.0）24（28.6）274（28.0）
每日3餐，每餐不足1/33（3/7）123（4.2）3（18.7）95（11.2）10（11.9）156（16.0）
既往疾病[例（%）]脑血管疾病1（1/7）448（15.3）1.0004（25.0）266（31.4）<0.00133（39.3）323（33.1）0.246
心血管疾病4（4/7）1 223（41.9）0.66411（68.8）450（53.2）<0.00150（59.5）541（55.4）0.462
阿尔茨海默病0（0/7）10（0.3）1.0001（6.3）29（3.4）0.5487（8.3)54（5.5）0.289
糖尿病1（1/7）585（20.0）1.0007（43.8）223（26.4）0.00230（35.7）245（25.1）0.033
恶性肿瘤3（3/7）910（31.2）0.2943（18.8）133（15.7）0.0087（8.3）94（9.6）0.700
自身免疫病0（0/7）38（1.3）1.0000（0.0）14（1.7）0.6181（1.2）10（1.0）0.598
帕金森综合征0（0/7）15（0.5）1.0000（0.0）22（2.6）0.2495（6.0）23（2.4）0.105
血液病0（0/7）55（1.9）1.0001（6.3）16（1.9）0.2754（4.8）15（1.5）0.087
瘫痪0（0/7）1（0.0）1.0000（0.0）8（0.9）1.0003（3.6）34（3.5）1.000
周围血管疾病0（0/7）48（1.6）1.0002（12.5）32（3.8）0.1285（6.0）34（3.5）0.393
肾脏疾病0（0/7）74（2.5）1.0001（6.3）47（5.6）0.6036（7.1）52（5.3）0.650
肺部疾病1（1/7）324（11.1）0.5622（12.5）130（15.4）1.00033（39.3）204（20.9）<0.001
全身麻醉大手术（近半年）0（0/7）133（4.6）1.0001（6.3）60（7.1）1.0005（6.0）96（9.8）0.246
用药史[例（%）]激素药0（0/7）184（6.3）1.0001（6.3）47（5.6）0.60310（11.9）83（8.5）0.289
免疫抑制药1（1/7）99（3.4）0.2160（0.0）13（1.5）1.0003（3.6）21（2.1）0.646
抗生素4（4/7）634（21.7）0.0704(25.0)252（29.8）0.88950（59.5）400（40.9）0.001
止痛药1（1/7）259（8.9）0.0441（6.3）113（13.4）0.64616（19.0）118（12.1）0.065
血管活性药0（0/7）329（11.3）1.0002(12.5)140（16.5）0.92624（28.6）151（15.5）0.002
抗凝药1（1/7）475（16.3）1.0004(25.0)205（24.2）1.00031（36.9）261（26.7）0.045
抗肿瘤药2（2/7）515（17.6）0.7931（6.3）80（9.5）0.9983（3.6)40（4.1）1.000
抗组胺药0（0/7）21（0.7）1.0000（0.0）5（0.6）1.0000（0.0）11（1.1）1.000
抗精神药0（0/7）25（0.9）1.0001（6.3）46（5.4）0.5960（0.0）50（5.1）1.000
镇静剂0（0/7）58（2.0）1.0001（6.3）31（3.7）0.45712（14.3）64（6.6）0.008
降血糖药1（1/7）525（18.0）1.0005（31.3）204（24.1）0.71525（29.8）211（21.6）0.084
降血压药4（4/7）942（32.2）0.3169（56.3）342（40.4）0.20231（36.9）369（37.8）0.875
利尿药1（1/7）215（7.4）0.4161（6.3）109（12.9）0.68220（23.8）199（20.4）0.455
使用减压床垫情况[例（%）]常规床垫3（3/7）2 728（93.4）<0.0019（56.2）704（83.2）0.00621（25.0）502（51.4）<0.001
海绵垫1（1/7）136（4.7）1（6.3）60（7.1）4（4.8）91（9.3）
动态充气垫3（3/7）44（1.5）6（37.5）65（7.7）54（64.2）342（35.0）
凝胶海绵/凝胶/其他材质床垫0（0/7）13（0.4）0（0.0）17（2.0）5（6.0）42（4.3）
受压处敷料[例（%）]无2（2/7）2 865（98.1）<0.00111（68.7）790（93.3）0.00630（35.7）722（73.9）<0.001
泡沫敷料5（5/7）44（1.5）4（25.0）41（4.9）43（51.2）228（23.3）
水胶体敷料0（0/7）12（0.4）1（6.3）15（1.8）11（13.1）27（2.8）
更换体位频率[例（%）]不规律翻身3（3/7）2 617（89.6）0.0047（43.8）660（78.0）0.0106（7.1）351（36.0）<0.001
≤2 h翻身1次4（4/7）264（9.0）9（56.2）178（21.1）78（92.9）611（62.5）
>2 h翻身1次0（0/7）40（1.4）0（0.0）8（0.9）0（0.0）15（1.5）
), ArticleFig(id=1322929638036615592, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, language=CN, label=表1, caption=

不同活动力老年人压力性损伤影响因素的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类独立活动（n=2 928）拄拐/搀扶/轮椅（n=862）卧床（n=1 061）
发生组（n=7）未发生组（n=2 921）P发生组（n=16）未发生组（n=846）P发生组（n=84）未发生组（n=977）P
性别[例（%）]男5（5/7）1 841（63.0）0.9468（50.0）537（63.5）0.26857（67.9）599（61.3）0.236
女2（2/7）1 080（37.0）8（50.0）309（36.5）27（32.1）378（38.7）
年龄（岁）82.0（73.0，86.0）71.0(68.0,76.0)0.02583.0（71.0，94.3）76.0（70.0，87.0）0.09679.5（72.0，92.0）75.0（69.0，88.0）0.016
学历[例（%）]文盲/小学3（3/7）1 325（45.4）0.8328（50.0）322（38.1）0.83225（29.8）360（36.8）0.009
初中2（2/7）878（30.1）2（12.5）214（25.3）13（15.5）251（25.7）
高中2（2/7）456（15.6）2（12.5）145（17.1）19（22.6）179（18.3）
专科及以上0（0/7）262（8.9）4（25.0）165（19.5）27（32.1）187（19.2）
主要照护者[例（%）]自护/家人5(5/7)2 781(95.2)11（68.7）631（74.6）0.63628（33.3）492（50.4）<0.001
护工/保姆2(2/7)128(4.4)0.0635（31.3）205（24.3）26（31.0）314（32.1）
护士0（0/7）12(0.4)0（0.0）10（1.1）30（35.7）171（17.5）
本次入住时长（d）12.0（4.0，16.0）5.0（3.0，9.0）0.05512.5（7.0，33.0）8.0（4.0，16.0）0.13114.0（7.0，30.5）9.0（5.0，20.0）<0.001
Braden评分(分)15.0（7.0，16.0）17.0（16.0，18.0）0.00912.0（10.0，13.0）15.0（12.0，16.0）0.0016.0（4.0，8.8）10.0（8.0，13.0）<0.001
营养途径[例（%）]经口7（7/7）2 841(97.3)1.00014（87.5）749（88.6）1.00023（27.4）562（57.5）<0.001
鼻饲/管饲0（0/7）42(1.4)2（12.5）61（7.2）55（65.5）347（35.5）
肠外0（0/7）0（0.0）0（0.0）19（2.2）0（0.0）40（4.1）
经皮胃造瘘技术/其他0（0/7）38(1.3)0（0.0）17（2.0）6（7.1）28（2.9）
每日饮水量1 500 mL[例（%）]是3(3/7)1 944(66.6)0.3557（43.7）427（50.5）0.59433（39.3）455（46.6）0.199
否4(4/7)977(33.4)9（56.3）419（49.5）51（60.7）522（53.4）
近1周排便情况[例（%）]失禁0（0/7）6（0.2）1.0001（6.3）21（2.5）0.34135（41.7）180（18.4）<0.001
自控/肠造口7（7/7）2 915（99.8）15（93.7）825（97.5）49（58.3）797（94.4）
近1周排尿情况[例（%）]失禁0（0/7）9（0.3）1.0001（6.3）27（3.2）0.17616（19.0）133（13.6）<0.001
自控7（7/7）2 839（97.2）13（81.3）778（92.0）20（23.9）504（51.6）
留置尿管/膀胱造瘘0（0/7）73（2.5）2（12.4）41（4.8）48（57.1）340（34.8）
失禁相关性皮炎[例（%）]是0（0/7）0（0.0）1.0000（0.0）1（0.1）1.00010（11.9）35（3.6）<0.001
否7（7/7）2 921（100.0）16（100.0）845（99.9）74（88.1）942（96.4）
饮食情况[例（%）]禁食禁水0（0/7）32（1.1）0.0050（0.0）13（1.5）0.4877（8.3）40（4.1）0.265
每日3餐均衡饮食3（3/7）2 427（83.1）7（43.8）493（58.3）43（51.2）507（51.9）
每日3餐，每餐>1/21（1/7）339（11.6）6（37.5）245（29.0）24（28.6）274（28.0）
每日3餐，每餐不足1/33（3/7）123（4.2）3（18.7）95（11.2）10（11.9）156（16.0）
既往疾病[例（%）]脑血管疾病1（1/7）448（15.3）1.0004（25.0）266（31.4）<0.00133（39.3）323（33.1）0.246
心血管疾病4（4/7）1 223（41.9）0.66411（68.8）450（53.2）<0.00150（59.5）541（55.4）0.462
阿尔茨海默病0（0/7）10（0.3）1.0001（6.3）29（3.4）0.5487（8.3)54（5.5）0.289
糖尿病1（1/7）585（20.0）1.0007（43.8）223（26.4）0.00230（35.7）245（25.1）0.033
恶性肿瘤3（3/7）910（31.2）0.2943（18.8）133（15.7）0.0087（8.3）94（9.6）0.700
自身免疫病0（0/7）38（1.3）1.0000（0.0）14（1.7）0.6181（1.2）10（1.0）0.598
帕金森综合征0（0/7）15（0.5）1.0000（0.0）22（2.6）0.2495（6.0）23（2.4）0.105
血液病0（0/7）55（1.9）1.0001（6.3）16（1.9）0.2754（4.8）15（1.5）0.087
瘫痪0（0/7）1（0.0）1.0000（0.0）8（0.9）1.0003（3.6）34（3.5）1.000
周围血管疾病0（0/7）48（1.6）1.0002（12.5）32（3.8）0.1285（6.0）34（3.5）0.393
肾脏疾病0（0/7）74（2.5）1.0001（6.3）47（5.6）0.6036（7.1）52（5.3）0.650
肺部疾病1（1/7）324（11.1）0.5622（12.5）130（15.4）1.00033（39.3）204（20.9）<0.001
全身麻醉大手术（近半年）0（0/7）133（4.6）1.0001（6.3）60（7.1）1.0005（6.0）96（9.8）0.246
用药史[例（%）]激素药0（0/7）184（6.3）1.0001（6.3）47（5.6）0.60310（11.9）83（8.5）0.289
免疫抑制药1（1/7）99（3.4）0.2160（0.0）13（1.5）1.0003（3.6）21（2.1）0.646
抗生素4（4/7）634（21.7）0.0704(25.0)252（29.8）0.88950（59.5）400（40.9）0.001
止痛药1（1/7）259（8.9）0.0441（6.3）113（13.4）0.64616（19.0）118（12.1）0.065
血管活性药0（0/7）329（11.3）1.0002(12.5)140（16.5）0.92624（28.6）151（15.5）0.002
抗凝药1（1/7）475（16.3）1.0004(25.0)205（24.2）1.00031（36.9）261（26.7）0.045
抗肿瘤药2（2/7）515（17.6）0.7931（6.3）80（9.5）0.9983（3.6)40（4.1）1.000
抗组胺药0（0/7）21（0.7）1.0000（0.0）5（0.6）1.0000（0.0）11（1.1）1.000
抗精神药0（0/7）25（0.9）1.0001（6.3）46（5.4）0.5960（0.0）50（5.1）1.000
镇静剂0（0/7）58（2.0）1.0001（6.3）31（3.7）0.45712（14.3）64（6.6）0.008
降血糖药1（1/7）525（18.0）1.0005（31.3）204（24.1）0.71525（29.8）211（21.6）0.084
降血压药4（4/7）942（32.2）0.3169（56.3）342（40.4）0.20231（36.9）369（37.8）0.875
利尿药1（1/7）215（7.4）0.4161（6.3）109（12.9）0.68220（23.8）199（20.4）0.455
使用减压床垫情况[例（%）]常规床垫3（3/7）2 728（93.4）<0.0019（56.2）704（83.2）0.00621（25.0）502（51.4）<0.001
海绵垫1（1/7）136（4.7）1（6.3）60（7.1）4（4.8）91（9.3）
动态充气垫3（3/7）44（1.5）6（37.5）65（7.7）54（64.2）342（35.0）
凝胶海绵/凝胶/其他材质床垫0（0/7）13（0.4）0（0.0）17（2.0）5（6.0）42（4.3）
受压处敷料[例（%）]无2（2/7）2 865（98.1）<0.00111（68.7）790（93.3）0.00630（35.7）722（73.9）<0.001
泡沫敷料5（5/7）44（1.5）4（25.0）41（4.9）43（51.2）228（23.3）
水胶体敷料0（0/7）12（0.4）1（6.3）15（1.8）11（13.1）27（2.8）
更换体位频率[例（%）]不规律翻身3（3/7）2 617（89.6）0.0047（43.8）660（78.0）0.0106（7.1）351（36.0）<0.001
≤2 h翻身1次4（4/7）264（9.0）9（56.2）178（21.1）78（92.9）611（62.5）
>2 h翻身1次0（0/7）40（1.4）0（0.0）8（0.9）0（0.0）15（1.5）
), ArticleFig(id=1322929638124695977, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, language=EN, label=Table 2, caption=

Multivariable analysis of factors associated with pressure injuries in elderly patients with different activity levels

, figureFileSmall=null, figureFileBig=null, tableContent=
组别变量回归系数标准误Wald χ2值POR值[95%CI]
独立活动组年龄0.1100.0544.1780.0411.117[1.005,1.242]
饮食情况1.3480.5017.2310.0073.851[1.441,10.289]
受压处敷料0.8250.4203.8660.0492.283[1.003,5.197]
拄拐/搀扶/轮椅组Braden评分-0.2110.0915.4150.0200.810[0.678,0.967]
卧床组学历0.3380.1257.2750.0071.402[1.097,1.792]
Braden评分-0.3830.06139.924<0.0010.682[0.605,0.768]
受压处敷料0.9160.21118.772<0.0012.500[1.652,3.783]
), ArticleFig(id=1322929638200193450, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322929629257937240, language=CN, label=表2, caption=

不同活动力老年人压力性损伤影响因素的多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
组别变量回归系数标准误Wald χ2值POR值[95%CI]
独立活动组年龄0.1100.0544.1780.0411.117[1.005,1.242]
饮食情况1.3480.5017.2310.0073.851[1.441,10.289]
受压处敷料0.8250.4203.8660.0492.283[1.003,5.197]
拄拐/搀扶/轮椅组Braden评分-0.2110.0915.4150.0200.810[0.678,0.967]
卧床组学历0.3380.1257.2750.0071.402[1.097,1.792]
Braden评分-0.3830.06139.924<0.0010.682[0.605,0.768]
受压处敷料0.9160.21118.772<0.0012.500[1.652,3.783]
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不同活动力老年病人压力性损伤发生率及其影响因素：一项多中心研究
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王亚玲 1 , 邓小炼 1 , 杨力 1 , 杜静 2 , 杜娟 1 , 张燕梅 1 , 李保松 1 , 王滕 1 , 刘琴 1 , 黄程程 1 , 蒋琪霞 2, *, *
护理研究 | 科研论著 2026,40(14): 2437-2443
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护理研究 |科研论著 2026 , 40 (14) : 2437 -2443
不同活动力老年病人压力性损伤发生率及其影响因素：一项多中心研究
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王亚玲1, 邓小炼1, 杨力1, 杜静2, 杜娟1, 张燕梅1, 李保松1, 王滕1, 刘琴1, 黄程程1, 蒋琪霞2, *, *
作者信息
  • 1陆军特色医学中心，重庆 404000
  • 2东部战区总医院
通讯作者:
蒋琪霞，E-mail：
JIANG Qixia, E-mail:
作者简介:

王亚玲，主任护师，博士研究生

Pressure injury incidence and influencing factors in elderly patients with different activity levels: a multicenter study
Yaling WANG1, Xiaolian DENG1, Li YANG1, Jing DU2, Juan DU1, Yanmei ZHANG1, Baosong LI1, Teng WANG1, Qin LIU1, Chengcheng HUANG1, Qixia JIANG2
Affiliations
  • 1Army Characteristic Medical Center, Chongqing 404000 China
  • 2Eastern Theater General Hospital
出版时间: 2026-07-25 doi: 10.12102/j.issn.1009-6493.2026.14.007
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摘要
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目的

探究不同活动力老年病人压力性损伤发生率及其影响因素。

方法

采取多中心横断面调查的方法，收集8所三级甲等医院的年龄≥65岁老年病人，按照统一培训的调研工具及方法收集纳入对象的一般资料、健康状况、皮肤检查资料和预防措施落实资料等。

结果

共纳入老年病人4 851例，发生压力性损伤107例，发生率为2.2%；独立活动组发生压力性损伤的老年人7例（0.2%），拄拐/搀扶/轮椅组16例（1.9%），卧床组84例（7.9%）。在独立活动组中，年龄、饮食情况、受压处的敷料类型为老年人压力性损伤的独立危险因素；在拄拐/搀扶/轮椅组中，Braden评分为老年人压力性损伤的独立危险因素；在卧床组中，学历、Braden评分、受压处敷料类型为老年人压力性损伤的独立危险因素。

结论

老年病人压力性损伤的发生率与其活动能力密切相关，活动能力越差，发生率越高。不同活动能力病人压力性损伤的危险因素存在差异，应针对独立活动、拄拐/搀扶/轮椅及卧床病人采取针对性的分层预防策略，重点关注高龄、营养、Braden评分、用药及局部敷料使用等关键因素，以有效降低压力性损伤的发生风险。

老年人  /  压力性损伤  /  活动能力  /  影响因素  /  营养  /  多中心  /  调查研究
Objective

To explore the pressure injury incidence and influencing factors in elderly patients with different activity levels.

Methods

A multicenter cross-sectional survey was conducted,enrolling elderly patients aged≥65 years from eight tertiary hospitals. Data on general information,health status,skin examination,and implementation of preventive measures were collected using uniformly trained research tools and methods.

Results

A total of 4 851 elderly patients were included,of whom 107 developed pressure injuries,resulting in an incidence rate of 2.2%.Among the independently mobile group,7(0.2%) developed pressure injuries.Among the crutches/assistance/wheelchairs group,16(1.9%) developed pressure injuries.Among the bedridden group,84(7.9%) developed pressure injuries.In the independently mobile group,age,dietary status,and type of dressing at pressure sites were independent risk factors for pressure injuries.In the crutches/assistance/wheelchair group,the Braden score was an independent risk factor.In the bedridden group,education level,Braden score and type of dressing at pressure sites were independent risk factors.

Conclusions

The incidence of pressure injuries in elderly patients is closely related to their activity levels,with lower activity levels associated with higher incidence rates.Risk factors for pressure injuries vary among patients with different activity levels.Targeted stratified prevention strategies should be implemented for independently mobile,crutches/assistance/wheelchair,and bedridden patients,focusing on key factors such as advanced age,nutrition,Braden score,medication use,and local dressing applications to effectively reduce the risk of pressure injuries.

elderly  /  pressure injury  /  activity ability  /  influencing factors  /  nutrition  /  multicenter  /  investigation study
王亚玲, 邓小炼, 杨力, 杜静, 杜娟, 张燕梅, 李保松, 王滕, 刘琴, 黄程程, 蒋琪霞. 不同活动力老年病人压力性损伤发生率及其影响因素：一项多中心研究. 护理研究, 2026 , 40 (14) : 2437 -2443 . DOI: 10.12102/j.issn.1009-6493.2026.14.007
Yaling WANG, Xiaolian DENG, Li YANG, Jing DU, Juan DU, Yanmei ZHANG, Baosong LI, Teng WANG, Qin LIU, Chengcheng HUANG, Qixia JIANG. Pressure injury incidence and influencing factors in elderly patients with different activity levels: a multicenter study[J]. Chinese Nursing Research, 2026 , 40 (14) : 2437 -2443 . DOI: 10.12102/j.issn.1009-6493.2026.14.007
正文
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世界人口的快速老龄化给全球医疗保健领域带来了巨大挑战[1]，全球超过65岁的人口占总人口的11.5%，预计到2050年，这一比例将增至22%[2]。国家统计局于2024年2月发布的《中华人民共和国2023年国民经济和社会发展统计公报》数据显示，截至2023年末，年龄大于65岁的老年人约21 676万人（占我国总人口的15.4%），这预示着我国即将进入深度老龄化社会[3]。压力性损伤（pressure injuries，PI）是老年人面临的一个严重而复杂的健康问题[4]。压力性损伤的发病机制是一个多因素的过程，包括炎症因素、激素变化、免疫保护降低、淋巴管阻塞、血液灌注受损和退行性变化等[5-6]。老年病人因皮肤老化导致皮肤干燥和瘙痒，皮下脂肪萎缩和底层骨骼结构对皮肤的支持减少协同降低了皮肤耐受性，增加了压力性损伤的易感性[7-8]。2019年，我国22个省的社区老年人纵向调查显示，不同省份老年人的压力性损伤现患率为2.2%~2.8%[9]。2021年一项研究显示，我国9个养老院1 385名老年人的压力性损伤现患率为4.8%[10]。2023年，一项基于我国20个省、自治区和直辖市52所医院的多中心研究报告，33 769例老年病人的压力性损伤现患率为3.1%[8]。且一项多中心横断面研究表明，影响老年病人（60岁以上）压力性损伤发生率的因素包括Braden评分、皮肤干燥的严重度、皮肤护理的独立性、失禁、白蛋白和血红蛋白水平、慢性病数量、性别、肺功能障碍和糖尿病等[8]。本研究在此基础上，继续探索临床上常见的老年压力性损伤影响因素以及合并症对住院老年病人压力性损伤发生率的影响。
1　对象与方法
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1.1　研究单位招募
东部战区总医院作为组长单位负责招募、审核合作中心，获医院伦理委员会批准（批文号：2022DZKY-065-02）后，在全军范围内公开招募，招募期为3个月。招募标准：1）有治疗或保健任务的综合性医院，其中干部保健科、特需病房、VIP病房或老年科床位≥150张；2）医院有运行成熟的皮肤护理或压力性损伤预防小组；3）医院或护理部领导支持；4）签署联合研究协议。招募结束后，共有8所军队三级甲等医院经课题组审核符合条件并签署双向研究协议作为多中心研究单位。8所研究单位地域分布：南京市2所，上海市1所，西安市1所，重庆市2所，郑州市1所，南宁市1所。
1.2　研究对象纳入与排除标准
纳入标准：1）因治疗或康复需要入住军队医院干部保健科或其他科室≥24 h的军队或地方保健对象；2）年龄≥65岁；3）能够配合从头到脚的皮肤检查；4）病人或家属签署知情同意书。排除标准：1）临终病人；2）病情紧急正在抢救；3）血液动力学不稳定，或因其他原因不能翻身检查；4）签署知情同意书后又要求退出研究者。
1.3　样本量计算
采用横断面研究的样本量估算公式：N=Z2αPQ/d2，式中α代表显著性水平，当α＝0.05时，Z=1.96；P为预期压力性损伤现患率，Q＝1-P，d为容许误差，参考我国多中心大样本研究获得老年人压力性损伤现患率（3.1%）[8]为预期现患率，容许误差d设定为0.5%，则调查所需样本量为4 616例。考虑到可能有3%的无效样本，最终至少需纳入样本4 759例。
1.4　研究工具
采用课题组研制并经过20名专家2轮函询修改形成的“老年人皮肤损伤流行病学和预防现况调研工具”[11]作为资料收集工具，工具的一致性信度为0.874，内容效度为0.95~1.00，有良好的便利性及实用性[11]。从病人一般资料（包括人口学资料、照顾情况等）、健康状况（包括慢性病、失禁情况等）、皮肤检查、Braden量表评分（包括6个条目，总分6~23分）、预防措施落实情况5个方面收集资料，预防措施方面主要收集使用减压垫、定时翻身、结构化失禁护理（包括管理失禁、及时清洗、润肤和护肤）的落实率[12]。
1.5　参研护士培训和考核
调研开始前4周，课题组对各研究中心参与研究的护理骨干采用腾讯会议进行线下结合线上的培训[13-14]，并将培训内容录制成视频，供各医院参训护士复习，培训1周后组织参训护士采用“问卷星”试卷在45 min内识别20张不同分期压力性损伤的图片，看图独立答题，提交试卷后考试通道关闭，每题5分，满分100分，成绩90分以上者为考核合格。8所医院共有273名护士参训，将考核合格者（210人）作为参研人员，年龄（38.38±11.02）岁，护龄为2~45年，学历均为本科及以上。
1.6　调研方法
以2023年7月17日作为横断面调研日，参照课题组以往多中心横断面调研的方法[8]，8所军队医院考核合格的210名护士每2人被分为1组，经过知情同意后，按照统一培训的调研工具及方法收集纳入研究对象的一般资料、健康状况、皮肤检查资料和预防措施落实资料，2名护士采用Braden量表为同一病人独立评分，如有分歧，请第3人独立评分，获取一致的评分结果。发现皮肤损伤，按照2019年国际指南对压力性损伤的定义标准和分期标准（1~4期、难以分期和深部组织损伤）进行识别[12,15]。调研结束后，2名护士均签名确认结果并用“问卷星”提交。病人的活动能力通过Barthel指数评定表评估，总分100分，>60分为生活基本自理，>40~60分为需帮助，20~40分为重度依赖，<20分为完全依赖。本研究调查问卷由专科护士和高年资护士床旁一对一发放并回收问卷，发放问卷4 851份，有效回收问卷4 851份，有效回收率100%。
1.7　统计学方法
采用SPSS 26.0软件进行数据分析，符合正态分布的定量资料采用均数±标准差（x±s）表示，组间比较采用t检验；不符合正态分布的定量资料采用中位数和四分位数[M(P25,P75)]表示，组间比较采用秩和检验；定性资料采用例数、百分比（%）表示，组间比较采用χ2检验或Fisher精确检验。采用多因素Logistic回归分析探讨不同活动能力老年病人压力性损伤的影响因素。以P<0.05为差异有统计学意义。
2　结果
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2.1　不同活动能力老年人压力性损伤影响因素的单因素分析
共获得有效样本4 851例，其中男3 047例（62.8%），女1 804例（37.2%）。独立活动2 928例（60.4%），拄拐/搀扶/轮椅862例（17.8%），卧床1 061例（21.9%）。发生压力性损伤的老年人107例，发生率为2.2%。独立活动组发生压力性损伤的老年人7例（0.2%），拄拐/搀扶/轮椅组16例（1.9%），卧床组84例（7.9%）。
单因素分析结果显示，在独立活动组中，年龄、Braden评分、饮食情况、止痛药、使用减压床垫情况、受压处敷料、更换体位频率对老年人压力性损伤有影响（P<0.05）；在拄拐/搀扶/轮椅组中，Braden评分、脑血管疾病、心血管疾病、糖尿病、恶性肿瘤、使用减压床垫情况、受压处敷料、更换体位频率对老年人压力性损伤有影响（P<0.05）；在卧床组中，年龄、学历、主要照护者、Braden评分、本次入住时长、营养途径、近1周排便情况、近1周排尿情况、失禁相关性皮炎、糖尿病、肺部疾病、抗生素、血管活性药、抗凝药、镇静剂、使用减压床垫情况、受压处敷料、更换体位频率对老年人压力性损伤有影响（P<0.05）。见表1。
2.2　不同活动力老年人压力性损伤影响因素的多因素分析
以单因素分析有统计学意义的变量为自变量，以老年人压力性损伤情况为因变量（未发生=0，发生=1），进行回归分析。多因素分析结果显示，在独立活动组中，年龄、饮食情况、受压处敷料为老年人压力性损伤的独立影响因素；在拄拐/搀扶/轮椅组中，Braden评分为老年人压力性损伤的独立影响因素；在卧床组中，学历、Braden评分、受压处敷料为老年人压力性损伤的独立影响因素。具体见表2。
3　讨论
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3.1　老年住院病人发生压力性损伤的流行特征
本研究发现，年龄是独立活动老年人发生压力性损伤的独立影响因素。老年病人在住院期间发生医院获得性压力性损伤（hospital-acquired pressure injuries，HAPI）的可能性较小，可能原因是老年病人引起了临床工作人员的更多关注和护理，这有效地降低了压力性损伤的发生率[16]。Alderden等[17]的研究也证实了这一观点，年龄与压力性损伤发生率之间的相关性无统计学意义。Ding等[16]的研究表明，男性发生压力性损伤的概率更高，老年压力性损伤发生在骶尾部椎体上的皮肤和下层软组织为52.2%，其次是股骨转子（为20.8%）、踝关节上（为13.5%）。这与在中国老年病人中进行的多中心横断面研究的结果相似，皮肤干燥影响的压力性损伤常见部位为骶骨和足跟[8, 10]。Meta分析结果显示，老年人压力性损伤最常见的分期是Ⅰ期、Ⅱ期，压力性损伤发生率分别为5.0%[95%CI(3.5%,6.8%)]和3.4%[95%CI(2.5%,4.5%)]，Ⅲ期、Ⅳ期压力性损伤的发生率分别为1.5%[95%CI(1.2%,1.9%)]和0.8%[95%CI(0.6%,1.6%)] [16]。Uslu等[18]的研究发现，93.3%在老年人中观察到的压力性损伤为Ⅰ期。
从本次研究对象的背景资料来看，90岁以下老年人中，87.8%的主要照护者为家人或自己，而90岁以上老年人中，69.5%是由专业的护工或保姆照护，其中100岁以上老年人中，保姆照护占24%，明显高于其他人群，专业贴心的照护水平可能在一定程度上降低了高龄人群的压力性损伤发生率，使得本研究中100岁以上人群压力性损伤的发生率低于95~100岁人群。
3.2　不同活动能力老年住院病人发生压力性损伤的影响因素
3.2.1　Braden评分
本研究发现，Braden评分是拄拐/搀扶/轮椅组、卧床组老年人发生压力性损伤的独立影响因素。由于大部分的压力性损伤是可以预防的，因此早期评估识别危险因素和积极采取干预措施十分重要。预防压力性损伤的国际临床实践指南（CPG）建议，病人在入院后不久或入院后8 h内应进行皮肤检查和风险评估[19]。Braden量表是一种通用的压力性损伤风险评估工具，虽然Braden评分的信效度在急性护理环境中得到了很好的验证，但由于研究之间的异质性，术前Braden评分可能无法准确反映术后压力性损伤的发生风险，因为它不包括与手术病人压力性损伤发展相关的术前变量，如年龄、体质指数（BMI）和重大合并症等，所以其预测压力性损伤的有效性较低[20]。此外，相关研究结果建议，虽然Braden评分是压力性损伤发展的一个独立影响因素，但不应单独使用Braden量表评估外科病人的压力性损伤风险[21-22]。入院时Braden评分可能不能代表整个住院期间发生压力性损伤的风险，用Braden评分进行动态评估可能会提高其预测价值[23]。Jiang等[8]的研究表明，Braden量表评分较低可以预测医院获得性压力性损伤。然而，还有研究发现，在入院时的社区获得性压力性损伤中，Braden量表及其分量表（营养分量表除外）的评分与医院获得性压力性损伤的发展相关性不明显[17]。除此之外，在Braden量表的营养分量表中，营养风险较低的病人发生压力性损伤的风险更高[17]。
3.2.2　皮肤/软组织保护
本研究发现，受压处敷料的类型是独立活动和卧床的老年人发生压力性损伤的独立影响因素。老年人皮肤干燥越严重，耐受性越差，皮肤越容易受到外力、失禁和气候的影响而发生压力性损伤[8]。预防性敷料如改良的水胶体敷料、柔软的硅胶泡沫敷料等可以较大限度地减少摩擦和剪切对皮肤的影响，敷料还可以保护完整的皮肤免受尿失禁的浸渍[24]。伤口护理敷料的选择建议：1）水凝胶敷料，适用于干燥伤口，有/没有结痂均可；2）薄膜，适用于小的渗出性伤口；3）水胶体敷料，适用于轻度渗出性伤口；4）泡沫敷料，适用于中度渗出性伤口；5）海藻酸盐和亲水纤维敷料，适用于高度渗出性伤口[24]。
3.2.3　疾病/药物影响
本研究多因素分析中，抗凝药对老年住院病人发生压力性损伤的影响无统计学意义（P>0.05），尚有待进一步验证。这与岳晓玲等[25]的研究结果结论（D-二聚体增高是老年病人发生压力性损伤的独立危险因素）不完全一致。本研究受样本量的影响，暂未发现其他药物治疗的影响，但使用其他药物仍然可能有其他的影响。其他的药物治疗，如皮质类固醇会阻止胶原纤维的形成，损害老年人皮肤的完整性；镇静剂会导致活动量减少；血管加压剂可增加平均动脉压，导致组织缺血、缺氧损伤，甚至四肢、肠系膜器官和肾脏坏死等，以上这些药物因素都会促进压力性损伤的发展[5, 16, 26]。
此外，本研究多因素分析中，基础疾病对老年压力性损伤的影响无统计学意义（P>0.05），这与我国一项研究结果（糖尿病和压力性损伤之间相关性无统计学意义）[7]相似。关于糖尿病是压力性损伤的独立危险因素，目前的研究尚具有争议。但有研究显示，糖尿病是除了心血管疾病之外压力性损伤病人常见的合并症之一[27]。有研究表明，糖尿病被认为是社区获得性压力性损伤的独立危险因素[16]。糖尿病病人有广泛的小血管内皮增生、缺氧和损伤、周围神经病变、皮肤敏感性低、异常出汗（多汗症、少汗或无汗），从而导致皮肤状况的变化，增加压力性损伤的发生风险[28]。2022年，Shilpa等[29]的研究表明，患有糖尿病的脑卒中幸存者压力性损伤的发生风险更高，可能原因是糖尿病导致的灌注不良、愈合缓慢和感觉下降等，增加了压力性损伤的发生风险。除此之外，癌症也被认为与中国社区老年人的社区获得性压力性损伤有关[9]。恶性肿瘤病人往往处于高分解代谢和低合成代谢状态，大量肌肉组织被消耗，进而导致身体退化、营养不良和身体的活动能力受损[7]。
3.2.4　饮食和学历
本研究结果显示，独立活动组老年患者每日维持均衡饮食，可作为压力性损伤的独立保护性因素，合理膳食有助于降低压力性损伤的发病风险。加拿大约有34%的老年人（65岁及以上）存在营养不良的风险,美国约有46%的住院老年患者存在营养不良[30]。蛋白质-热量营养不良（protein-calorie malnutrition，PCM）导致皮肤的弹性减弱，通常会促进压力性损伤的形成[31-32]。压力性损伤部位的皮肤需要充足的能量如脂肪酸、蛋白质、微量营养素和液体来维持自身生长、增加细胞活性和胶原蛋白合成[32]。氨基酸，尤其是精氨酸和谷氨酰胺对组织修复、成纤维细胞增殖、胶原合成、血管生成和免疫功能至关重要[32]。2022年，Dario等[33]的研究发现，营养不良可以影响压力性损伤伤口的愈合，可能原因是营养不良会延迟组织的修复过程。目前，营养不良已被公认是影响伤口愈合的可干预风险因素[30]。此外，本研究发现，卧床组老年病人的学历水平低也是压力性损伤的风险因素之一。低学历老年病人健康素养普遍不足，对压力性损伤预防的认知存在明显短板。一方面，该群体自主学习能力薄弱，难以掌握减压、皮肤清洁、营养支持等关键防控手段；另一方面，健康理念滞后，常常忽视局部受压带来的组织损伤。临床护理工作中，针对低文化程度老年人群单纯开展书面宣教效果有限，需要医护人员采用口头讲解、实景演示等通俗易懂的方式开展个性化健康教育，以此弥补认知短板，降低压力性损伤的发生率。
4　小结
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随着世界人口老龄化问题的加剧，老年病人的压力性损伤护理预防问题也是全球不容忽视的卫生问题。压力性损伤的预防措施包括风险因素评估、皮肤/软组织评估和保护、营养支持、适当的支撑面和复位[16]。目前，国内外也积极采取院内护理、多学科合作护理和多学科伤口护理等护理模式积极进行压力性损伤护理干预。未来，随着护理水平的不断提高，将对压力性损伤的基因层面和危险因素有进一步的认识，有利于为预防压力性损伤提供更多依据。

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2026年第40卷第14期
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doi: 10.12102/j.issn.1009-6493.2026.14.007
  • 接收时间：2025-02-18
  • 首发时间：2026-10-30
  • 出版时间：2026-07-25
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  • 收稿日期：2025-02-18
  • 修回日期：2026-06-15
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    1陆军特色医学中心，重庆 404000
    2东部战区总医院

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蒋琪霞，E-mail：
JIANG Qixia, E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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