基于德尔菲-熵权法的碘对比剂外渗风险评估体系的构建  

Construction of risk assessment system for iodine contrast agent extravasation based on Delphi-entropy weight method

作　　者：姚金秀 董芳辉[2] 梅申聪[3] 杨丽娜[3] 张亚娟 YAO Jinxiu;DONG Fanghui;MEI Shencong;YANG Li'na;ZHANG Yajuan(Department of Otorhinolaryngology Head and Neck Surgery,Shanghai Sixth People's Hospital,Shanghai 201306,China;Department of Nursing,Shanghai Sixth People's Hospital,Shanghai 201306,China;Outpatient Clinic,Shanghai Sixth People's Hospital,Shanghai 201306,China;Department of Critical Care Medicine,Shanghai Sixth People's Hospital,Shanghai 201306,China)

机构地区：[1]上海市第六人民医院耳鼻咽喉头颈外科,上海201306 [2]上海市第六人民医院护理部,上海201306 [3]上海市第六人民医院门诊,上海201306 [4]上海市第六人民医院重症医学科,上海201306

出　　处：《护士进修杂志》2024年第9期945-949,共5页Journal of Nurses Training

基　　金：上海市第六人民医院医疗集团课题(编号:LY33.横-2020005);上海交通大学医学院护理学科建设项目(编号:SJTUHLXK2023)。

摘　　要：目的联合德尔菲法和熵权法构建碘对比剂静脉外渗风险评估体系,为碘对比剂使用风险筛查提供参考依据。方法以4R危机管理理论为指导,通过文献循证研究,结合临床数据回顾分析,形成碘对比剂外渗风险评估体系初稿,采用目的抽样的方法选取20名长期从事碘对比剂外渗研究的医学、护理专家,运用德尔菲(Delphi)法进行评估体系的修订,最后应用熵权法确定指标权重系数。结果碘对比外渗风险评估体系包括患者因素、注射因素、药物因素、疾病因素4个维度(一级指标),根据不同维度的特征确定了13个二级指标,对二级指标应用熵权法进行权重计算,确定了年龄、导管留置时间、导管留置部位、基础疾病和血管情况5个关键指标。结论基于德尔菲—熵权法构建的碘对比剂静脉外渗风险评估体系具有重要性、科学性和实用性,可为碘对比剂静脉外渗风险评估提供科学依据。Objective To combine Delphi method and entropy weight method to construct the risk assessment system for intravenous extravasation of iodine contrast medium,and to provide a reference for the risk screening of iodine contrast medium use.Methods Guided by the 4R crisis management theory,through literature evidence-based research,combined with clinical data review and analysis,the first draft of the risk assessment system for iodine contrast agent extravasation was formed.A total of 20 medical and nursing experts who had been engaged in the research of iodinated contrast agent extravasation for a long time were selected by purposive sampling method,and Delphi method was used to modify the evaluation system.Finally,entropy weight method was used to determine the index weight coefficient.Results The iodine contrast extravasation risk assessment system included 4 dimensions(first-level indicators)of patient factors,injection factors,drug factors,and disease factors.According to the characteristics of different dimensions,13 second-level indicators were determined,and the entropy weight method was applied to calculate the weight of the second-level indicators,and 5 key indicators including age,catheter indwelling time,catheter indwelling site,basic diseases,and vascular conditions were determined.Conclusion The risk assessment system of iodine contrast agent venous extravasation based on Delphi-entropy weight method is important,scientific,and practical,and can provide a scientific basis for the risk assessment of iodine contrast agent venous extravasation.

关 键 词：德尔菲 熵权法 碘对比剂 静脉外渗 风险评估 

分 类 号：R472[医药卫生—护理学]