尿流量动态监测仪的测量精确度及临床适用性研究  

Accuracy of urine output dynamic monitoring and its clinical applicability

作　　者：曾庆玲 王开发[2] 李永勤[2] 高鹏[2] 黎宁 陶莉菊 郝芬 武艳军 罗奇志 王庆梅 ZENG Qingling;WANG Kaifa;LI Yongqin;GAO Peng;LINing;TAO Liju;HAO Fen;WU Yanjun;LUO Qizhi;WANG Qingmei(Department of Nursing,Army Medical University (Third Military Medical University),Chongqing,400038;Department of Medical Equipment and Metrology,Faculty of Biomedical Engineering,Army Medical University (Third Military Medical University),Chongqing,400038;State Key Laboratory of Trauma,Burns and Combined Injury,Institute of Burns,First Affiliated Hospital,Army Medical University (Third Military Medical University),Chongqing,400038;Department of Nursing,Chinese PLA General Hospital)

机构地区：[1]陆军军医大学(第三军医大学)第一附属医院护理部,重庆400038 [2]陆军军医大学(第三军医大学)生物工程医学系卫生装备与计量学教研室,重庆400038 [3]陆军军医大学(第三军医大学)第一附属医院全军烧伤研究所,创伤,烧伤与复合伤国家重点实验室,重庆400038 [4]解放军总医院护理部,北京100853

出　　处：《第三军医大学学报》2019年第2期158-162,共5页Journal of Third Military Medical University

基　　金：全军"十二五"医药卫生科研项目(CWS11C133);陆军军医大学第一附属医院军事医学与创伤救治临床新技术计划(SWH2016YSCXZD-11)~~

摘　　要：目的对每小时尿量人工监测与尿流量动态监测仪监测的精度进行对比研究。方法对2017年9月至2018年7月收入陆军军医大学第一附属医院烧伤研究所ICU进行治疗的68例烧伤患者的尿量监测数据进行前瞻性分析。对按医嘱需要进行每小时尿量监测的患者,按照入院时间先后进行随机分组。根据尿量监测的方法分为人工监测组(对照组,34例)和设备监测组(试验组,34例),每名患者监测时间为8 h。对照组由护士目测一次性集尿袋刻度监测患者尿量值,试验组使用尿流量动态监测仪自动监测患者尿量,2组均使用量筒对该小时尿量进行复测。统计2组患者每小时尿量值,并与量筒所测得的该小时尿量标准值进行对照。记录对照组患者每小时尿量实际测量时间点。对数据进行Kolmogorov-Smirnov检验、Mann-Whitney U检验、线性回归分析和χ2检验。结果人工测量对照组测量偏差值的中位数为15.00 mL,测量偏差率的中位数为17.75%,高于试验组的偏差值(2.00 mL)和测量偏差率(1.71%),差异具有统计学意义(P<0.001)。试验组的可决系数(R2=0.999)高于对照组(R2=0.860),并且试验组回归方程的斜率(0.988)比对照组(0.890)更加接近1。试验组在可接受误差范围内的百分比(93.75%)与对照组(14.00%)之间差异具有统计学意义(P<0.001);对照组和试验组均有272个尿量测量时间点,其中对照组的准点测量次数仅为34次(12.50%),最大测量时间误差为20 min,中位数为10 min;而试验组的所有实际测量时间点均与计划测量时间点一致,无测量时间误差。χ2检验结果表明两组测量时间准点率的差异具有统计学意义(P<0.001)。结论尿流量动态监测仪的测量精度远高于人工监测,具有更好的临床适用性,有临床推广价值。Objective To compare the accuracy of measuring urine output in hours manually and with a urine output dynamic monitor.Methods A total of 68 burned patients admitted to Institute of Burns of the First Affiliated Hospital from September 2017 to July 2018 were prospective recruited in this study.All these patients were required for hourly monitoring of urine output under doctor’s orders.According to the time of admission,they were randomly assigned into manual monitoring group(control group,n=34) and device monitoring group(trial group,n=34).Their data of hourly urine output were collected for 8 h,and those from the control group were conducted by a nurse visually reading the scale on the disposable urine bag and then re-measuring the volume with a measuring cylinder.The volume of the trial group were dynamically recorded by the monitor,and also re-measured by a measuring cylinder.The hourly urine volume at each time point was compared between the 2 groups,and also with the standard volume measured by the cylinder.The obtained data were processed with Kolmogorov-Smirnov test,Mann-Whitney U test,linear regression analysis and Chi-square test.Results The median of measurement deviation was 15.00 mL and the measurement deviation rate was 17.75% in the control group,which was significantly higher than those of the trial group(2.00 mL and 1.71%,P<0.001).The trial group had a better resolvable coefficient(R2=0.999),and its slope of the regression equation(0.988) was closer to 1,when compared with the control group(R^2=0.860,0.890).The percentage within the acceptable error range was significantly higher in the trial group than the control group(93.75% vs 14.00%,P<0.001).Among the 272 time points of monitoring,punctual measuring was only 34 times(12.50%) in the control group,and the maximal time error was 20(median 10).But for the trial group,the punctual measuring was obtained at every time point.Chi-square test showed that statistical difference was found in the punctuality ratio of measurement time between the 2 group

关 键 词：尿量 监测 精度 烧伤监护室 

分 类 号：R197.39[医药卫生—卫生事业管理] R334.4[医药卫生—公共卫生与预防医学]