简化COMFORT量表评估机械通气患儿镇静水平的信度和效度  

The reliability and validity of simplified COMFORT scale in assessment of sedation levels in children on mechanical ventilation

作　　者：冯裕广[1] 孙立平[1] 王助衡[1] 李玉伟[1] 郭清华[1] 周冠华[1] 

机构地区：[1]首都医科大学大兴医院,北京102600

出　　处：《临床儿科杂志》2014年第12期1158-1161,共4页Journal of Clinical Pediatrics

摘　　要：目的：探索采用简化COMFORT量表评估机械通气患儿镇静水平时，不同评价者之间以及与脑电双频指数（BIS）的一致性，从而确定其信度、效度和临床应用前景。方法以重症监护病房3～16岁接受机械通气和镇静治疗的患儿为研究对象，以简化COMFORT量表（不包括心率和血压）进行镇静分层评估，同时记录BIS监测数值。由4名专业医师独立完成评估，计算评估者相互之间Kappa值，分析简化COMFORT量表与BIS结果之间相关性。结果共纳入20例患儿，进行了70次评估。4名评分者相互之间的Kappa值为0.62～0.77（P＜0.001）；简化COMFORT量表与BIS结果之间成正相关（r=0.53～0.61，P均＜0.01）。结论简化COMFORT量表在不同的评价者以及与BIS之间均显示出较高的一致性，具有较好的信度和效度，可用于机械通气患儿镇静水平评估。Objective To compare the scores from the simpliifed COMFORT scale with those from the bispectral index （BIS） and analyze the variation among different evaluators in children in an intensive care unit, and to investigate the reliability;validity of simpliifed COMFORT scale. Methods Twenty children between 3 and 16 years of ages on mechanical ventilation and sedation were simultaneously classiifed based on the BIS and the simpliifed COMFORT scale evaluated by 4 independent evalua-tors. The Kappa test was performed and the correlation between the two methods （Pearson correlation） was tested. Results In to-tal, 70 observations were performed on 20 patients. Based on the Kappa coefifcient, the agreement among evaluators ranged from 0.62 to 0.77 （P〈0.001）. There was a correlation between the BIS and the simpliifed COMFORT scale （r=0.53-0.61,P〈0.01）. Conclusions Due to the strong consistency between the independent evaluators and the correlation between the two methods, the reliability and validity of simpliifed COMFORT scale are preferable and simpliifed COMFORT scale is useful in classifying the level of sedation in children on mechanical ventilation.

关 键 词：机械通气 儿童 镇静 信度 效度 

分 类 号：R726.1[医药卫生—儿科]