基于腹内压分级的ICU腹腔高压患者肠内营养护理方案的构建  

Construction of enteral nutrition nursing scheme for patients with abdominal hypertension in ICU based on intra-abdominal pressure classification

作　　者：王梅梅 乔安花 王银娥 周丙梅 李文放 彭飞 Wang Meimei;Qiao Anhua;Wang Yin′e;Zhou Bingmei;Li Wenfang;Peng Fei(Department of Emergency Surgery,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China;School of Nursing,Soochow University Medical University,Suzhou 215006,China;Department of Nursing,Shanghai Changzheng Hospital,Shanghai 200000,China;Department of Critical Care Medicine,Shanghai Changzheng Hospital,Shanghai 200000,China)

机构地区：[1]蚌埠医科大学第一附属医院急诊外科,蚌埠233000 [2]苏州大学医学部护理学院,苏州215006 [3]上海长征医院护理处,上海200000 [4]上海长征医院重症医学科,上海200000

出　　处：《中国实用护理杂志》2024年第15期1133-1141,共9页Chinese Journal of Practical Nursing

基　　金：上海申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC 22022205)。

摘　　要：目的构建基于腹内压分级ICU腹腔高压患者肠内营养护理方案,为有效预防ICU腹腔高压患者肠内营养不耐受提供借鉴。方法参照"6S"证据金字塔模型,由上而下依次检索BMJ最佳临床实践、Cochrane Library、国际指南协作网、医脉通、UpToDate、PubMed、Ovid、Web of Science、Embase、中国知网、维普、万方医学、中国生物医学文献数据库等数据库中关于腹腔高压ICU患者实施肠内营养支持的相关文献,拟定基于腹内压分级的ICU腹腔高压患者肠内营养护理方案,检索日期为建库至2023年1月25日;运用德尔菲专家函询法对20名专家进行2轮函询,征询专家意见,确定干预方案。结果专家年龄(43.75±5.28)岁,工作年限为(22.00±6.98)年。2轮德尔菲专家函询问卷的有效回收率均为100%(20/20),专家判断依据系数分别为0.945、0.970,熟悉程度系数分别为0.865、0.895,权威系数为0.905、0.932;2轮专家函询一、二、三级条目重要性Kendall协调系数分别为0.100、0.093、0.098和0.200、0.165、0.119,一、二、三级条目可操作性Kendall协调系数分别为0.117、0.130、0.115和0.200、0.184、0.154。最终形成包含5个一级条目,30个二级条目,51个三级条目的基于腹内压分级ICU腹腔高压患者肠内营养护理方案。结论本研究德尔菲法专家权威程度和积极性较高,专家意见协调程度较好,构建的基于腹内压分级的ICU腹腔高压患者肠内营养护理方案具有可靠性和科学性,可为ICU腹内高压患者肠内营养临床护理实践提供参考。Objective To construct the enteral nutrition nursing scheme of ICU patients with abdominal hypertension based on internal abdominal pressure classification,and provide reference for effectively preventing enteral nutrition intolerance of ICU patients with abdominal hypertension.Methods According to the"6S"evidence pyramid model,searched from top to bottom for relevant literature on enteral nutrition support for ICU patients with abdominal hypertension in databases such as BMJ Best Practice,Cochrane Library,Guidelines International Network,Medlive,UpToDate,PubMed,Ovid,Web of Science,Embase,China National Knowledge Infrastructure,VIP,Wanfang Medicine,Chinese Biomedical Literature.Developed an enteral nutrition care plan for ICU patients with abdominal hypertension based on intra-abdominal pressure grading,with a search date from database establishment to January 25,2023.The Delphi expert letter consultation method was used to conduct two rounds of letter consultation with 20 experts to solicit expert opinions and determine the intervention plan.Results The age of 20 experts was(43.75±5.28)years old,with a working experience of(22.00±6.98)years.The effective recovery rates of the two rounds of Delphi expert correspondence questionnaires were 100%(20/20),the expert judgment basis coefficients were 0.945 and 0.970,the familiarity coefficients were 0.865 and 0.895,and the authority coefficients were 0.905 and 0.932,respectively.Kendall coordination coefficient of importance of the first,second and third level items in the two rounds of expert correspondence were 0.100,0.093,0.098 and 0.200,0.165,0.119.The Kendall coordination coefficients of operability for the first,second and third level items were 0.117,0.130,0.115 and 0.200,0.184,0.154,respectively.Finally,an enteral nutrition nursing scheme for patients with abdominal hypertension in ICU was formed,which included 5 primary items,30 secondary items and 51 tertiary items.Conclusions The Delphi method in this study has a high degree of authority and enthusiasm of e

关 键 词：重症监护病房 德尔菲技术 腹内压分级 腹腔高压 肠内营养 

分 类 号：R472[医药卫生—护理学]