儿科手术患者术中获得性压力性损伤风险评估量表的构建及应用研究  

Study on construction and application of a risk assessment scale for intraoperative acquired stress injury in pediatric surgery patients

作　　者：陈思[1] 彭丽红[1] 刘小艳[1] 滕思思[1] CHEN Si;PENG Lihong;LIU Xiaoyan;TENG Sisi(Department of Anesthesiology and Surgery,Hunan Children’s Hospital,Hunan Province,Changsha 411100,China)

机构地区：[1]湖南省儿童医院麻醉手术科,湖南长沙411100

出　　处：《中国医药导报》2024年第15期81-84,共4页China Medical Herald

基　　金：湖南省卫生健康科研计划项目(D202314048475)。

摘　　要：目的 构建儿科手术患者术中获得性压力性损伤(IAPI)风险评估量表并探讨其应用效果。方法 选取2022年8月至2023年5月湖南省儿童医院106例儿科手术患者为研究对象,通过文献回顾和德尔菲专家函询,生成IAPI风险评估量表,将函询后生成的量表应用到临床,开展信效度检验及预测IAPI发生的效能。结果 两轮函询结果显示,专家积极性较高、权威程度较高、意见比较集中、一致性较高。最终量表包括手术时间、体位、美国麻醉医师协会分级、营养状态、体重指数、术中受压处皮肤情况、术前肢体活动、组织灌注8个条目,量表Cronbach’s α系数为0.705,分半信度为0.725,问卷水平内容效度指数为0.832,条目水平内容效度指数为0.805~1.000。使用Munro量表作为效标,术前、术中、术后评分的相关系数分别为0.377、0.415、0.513。量表预测IAPI发生的曲线下面积为0.810,灵敏度为70.8%、特异度为81.5%、临界值为13.5分。结论 构建的量表具有较高的权威性和科学性,可作为儿科手术患者IAPI风险的评估工具。Objective To construct a risk assessment scale for intraoperative acquired pressure injury(IAPI) in pediatric surgical patients and explore its application effectiveness.Methods A total of 106 pediatric surgical patients in Hunan children's Hospital from August 2022 to May 2023 were selected as research object.The IAPI risk assessment scale was generated through literature review and Delphi expert consultation.The scale generated after the consultation was applied to the clinic to carry out the reliability and validity test,and the efficiency of predicting the occurrence of IAPI.Results The results of two rounds of correspondence showed that the experts had higher enthusiasm,higher authority,more concentrated opinions,and higher consistency.The final scale included eight items,including operation time,body position,American Society of Anesthesiologists grade,nutrition status,body mass index,skin condition at the pressure during operation,preoperative limb activity,and tissue perfusion.The Cronbach's α coefficient of scale was 0.705,split half reliability was 0.725,questionnaire level content validity index was 0.832,and item level content validity index was 0.805-1.000.Using Munro scale as the criterion,the correlation coefficients of preoperative,intraoperative,and postoperative scores were 0.377,0.415,and 0.513,respectively.The scale predicted IAPI occurrence with an area under the curve of 0.810,sensitivity of70.8%,specificity of 81.5%,and cut-off value was 13.5 points.Conclusion The scale constructed is highly authoritative and scientific,and can be used as a risk assessment tool for pediatric surgery patients with IAPI.

关 键 词：儿科手术患者 术中获得性压力性损伤 风险评估 量表 信效度检验 影响因素 

分 类 号：R726.1[医药卫生—儿科]