一位患有薦骨壓瘡的臥床病人需要翻身，建議的頻率為何？

壓力性損傷（Pressure Injury），俗稱壓瘡，是由於局部組織長期承受壓力，導致血流受阻，組織缺氧、營養不良而壞死。預防壓瘡的關鍵在於減輕和分散壓力，促進血液循環。對於臥床病人，特別是已出現壓瘡的病人，定時變換姿勢（Repositioning）是核心的護理措施。 國際壓瘡諮詢小組（PPPIA）和多數臨床指引建議，對於有壓瘡風險或已患有壓瘡的病人，應每 2 小時翻身一次。這個頻率的目的是確保身體各部位，尤其是骨突處（如薦骨、髖骨、腳跟、肩胛骨等），不會持續承受過大的壓力超過 2 小時，從而給予組織恢復血液供應和氧氣的時間，預防或促進癒合。 選項 B 是正確的。每 2 小時翻身一次是預防和管理壓瘡的標準臨床實務（Standard practice）。 選項 C 是錯誤的。每 1 小時翻身一次雖然更頻繁，但對於大多數臥床病人而言，可能過於頻繁且不切實際，除非病人有極高的壓瘡風險或處於急性惡化階段，且需根據具體情況調整，2 小時是普遍接受的標準。 選項 A 是錯誤的。每 4 小時翻身一次的間隔時間太長，無法有效預防或減緩壓瘡的發展，組織受壓時間過長，容易導致進一步損傷。 選項 D 是錯誤的。每班次（Shift）翻身一次（通常為 8 小時）的間隔時間遠遠不夠，絕對不足以預防壓瘡的形成或惡化。 臨床思路：壓瘡的預防與治療遵循「移除壓力源」的原則。對於臥床病人，定時翻身是移除壓力最直接有效的方法。頻率的選擇基於組織耐受壓力的時間，2 小時是目前臨床上廣泛採納的標準。

Pressure injuries, commonly known as pressure ulcers, develop when localized tissue is subjected to prolonged pressure, causing impaired blood flow, hypoxia, and tissue malnutrition leading to necrosis. The key to pressure-injury prevention is to relieve and distribute pressure and to promote circulation. For bedridden clients—especially those who already have pressure injuries—scheduled repositioning is the cornerstone nursing intervention. The International Pressure Ulcer Advisory groups (such as NPUAP/EPUAP/PPPIA) and most clinical guidelines recommend repositioning every 2 hours for clients at risk for or with existing pressure injuries. The purpose of this frequency is to ensure that body parts—particularly bony prominences such as the sacrum, hips, heels, and scapulae—do not bear excessive pressure for more than 2 hours, allowing the tissue time to restore blood supply and oxygenation and thus to prevent injury or promote healing. Option B is correct. Repositioning every 2 hours is the standard clinical practice for preventing and managing pressure injuries. Option C is incorrect. Although repositioning every 1 hour is more frequent, for most bedridden clients it is too frequent and impractical unless the client is at extremely high risk or in acute deterioration; the schedule must be tailored to the situation, with 2 hours being the widely accepted standard. Option A is incorrect. A 4-hour interval is too long to effectively prevent or slow the development of pressure injuries; prolonged tissue compression readily leads to further damage. Option D is incorrect. Repositioning once per shift (usually 8 hours) is far too infrequent and clearly insufficient to prevent the formation or progression of pressure injuries. Clinical reasoning: The prevention and treatment of pressure injuries follow the principle of "removing the source of pressure." For bedridden clients, scheduled repositioning is the most direct and effective way to remove pressure. The frequency is determined by the tissue tolerance time, with 2 hours being the currently accepted standard in clinical practice.