HRONIČNE DEKUBITALNE RANE KOD TRAUMATSKIH I NETRAUMATSKIH PACIJENATA U JEDINICAMA INTENZIVNOG LEČENJA
Sažetak
Uvod/Cilj: Dugoležeći pacijenti u bolnicama, staračkim domovima, a naročito u jedinicama intenzivnog lečenja, izloženi su riziku od nastanka hroničnih rana. Termin „hronična rana“ se odnosi na rane koje ne zarastaju uprkos svim preduzetim merama lečenja u vremenskom trajanju od šest do osam nedelja. Cilj ove retrospektivne kohortne studije je bio da se za petogodišnji period analiziraju podaci o hroničnim dekubitalnim ranama koji su prikupljeni u jedinicama intenzivnog lečenja (JIL) Urgentnog centra Univerzitetskog Kliničkog Centra Srbija sa ciljem utvrđivanja faktora koji utiču na njihov nastanak i zarastanje.
Metode: Retrospektivna kohortna studija je izvedena u periodu od 01.01.2018. do 01.04.2023. godine u Urgentnom centru Univerzitetskog Kliničkog Centra Srbije i to u JIL politraumatskih, neurohirurških i hirurških pacijenata. Studija je obuhvatila 74 pacijenta sa dijagnozom hroničnih dekubitalnih rana. Za sve ispitanike podaci su dobijeni iz istorije bolesti i otpusne liste.
Rezultati: Tokom intrahospitalnog lečenja u JIL dekubitalne rane su evidentirane kod svih 74 pacijenata (56,8% žena i 43,2% muškaraca), a kombinovane hronične rane kod 57 (77,0%). Najveći broj ovih pacijenata je bio starijeg uzrasta (70 i više godina) (31,1%) i sa netraumatskim povredama (62%). Svi pacijenti su bili traheotomisani sa plasiranom gastrostomom. Lokalizacija dekubitalnih rana je najčešće bila na lumbosakralnoj regiji (44,6%), a zatim u trohanteričnoj regiji (23,0%). Među pacijentima najviše je bilo osoba sa hipertenzijom (90,5%), dijabetesom (79,7%) i hroničnom opstruktivnom bolešću pluća (82,4%), a do smrtnog ishoda je došlo kod 28 (37,8%) pacijenata. Neuhranjenost je bila prisutna kod 38 (51,4%), a prekomerna telesna težina i gojaznost kod 11 (14,9%) pacijenata.
Zaključak: Faktore rizika za nastanak dekubitusnih rana treba proceniti u trenutku prvog kontakta lekara sa nepokretnim pacijentom jer je to jedini preduslov za pravovremenu prevenciju. Poseban akcenat treba staviti na starije osobe, pothranjenje i osobe sa komorbiditetima.
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