Ramsay评分在神经外科术后患者中应用的信度和效度  

Reliability and Validity of The Ramsay Scale in Post-operative Neurosurgical Patients

作　　者：陈律[1] 李桂云[1] 蔡卫新[1] 张雪梅[1] 王玉新[1] 张峥[1] 石广志[1] 徐明[1] 周建新[1] 

机构地区：[1]首都医科大学附属北京天坛医院重症医学科,北京100050

出　　处：《中国医药导刊》2011年第12期2105-2106,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:检验使用标准化流程的Ramsay评分表(RS)用于评估神经外科术后患者的躁动与镇静状况时的信度和效度。方法:选择78例成年神经外科全麻术后患者,于术后24小时内纳入试验,由4～6名评估者同时对其评定RS和格拉斯哥昏迷量表(GCS)。检验两评估者间的信度和两评分表比较的结构效度。结果:RS和GCS的加权Kappa值(k w)分别为0.81(0.72-0.91)和0.92(0.87-0.98),P均<0.0001。两评分表比较的相关系数r=0.87,P<0.001。结论:使用标准化流程的RS在神经外科术后患者中应用时,具有很好的信度和效度。Objective：To test the reliability and validity of the Ramsay Scale in post-operative neurosurgical patients,by using a standardized procedure for assessment.Methods：Seventy-eight adult post-operative neurosurgical patients in our ICU were enrolled from January to March,2007.Inter-rater reliability was determined for the RS and GCS by comparing ratings between a predetermined doctor and a nurse,using weighted Kappa indices and 95%confidence intervals.For construct validity test,the Spearman correlation coefficient （r） was calculated for the associations between RS and GCS in observations of all 8 raters.Results：In 51-paired observations by the two predetermined raters,both the RS and the GCS demonstrated very good inter-rater reliability（weighted k,0.81 and 0.92,respectively; P0.001 for both comparisons）.To compare the RS to the GCS,226 observations by 8 raters showed excellent correlation（r=0.87,P0.001）. Conclusion：The RS demonstrated very good inter-rater reliability and excellent construct validity in post-operative neurosurgical patients. Thus,the routine use of the RS in clinical practice and monitoring for these patients is viable.

关 键 词：RAMSAY评分 镇静 躁动 神经外科 术后 信度 效度 

分 类 号：R651[医药卫生—外科学]