[构建心肺旁路心脏手术后患者高氧血症风险因素评估表]。

Yi Yang, Jianquan Li, Linlin You, Zhixia Jiang
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引用次数: 0

摘要

目的根据德尔菲法构建心肺旁路心脏手术后患者高氧血症风险因素评估表,为早期预测和评估心脏手术后患者的高氧血症风险提供依据:方法:成立研究小组。根据体外循环心脏手术的特点,检索各数据库截至2022年10月发表的中英文文献,结合相关专业临床医生的意见,筛选心肺搭桥心脏手术后患者高氧血症的危险因素,初步拟定《心肺搭桥心脏手术后患者高氧血症危险因素评估表》。采用德尔菲法进行了两轮专家函询,对初稿进行了补充和完善,最终确定了《心肺搭桥心脏手术后患者高氧血症危险因素评估表》定稿:根据文献综述和相关专业临床医生的意见,构建了心肺搭桥术后患者高氧血症危险因素评估表初稿,共包含 4 个维度、21 个条目。共函询了 14 位专家,其中正高职称 5 人,副高职称 9 人。其中 6 人主修重症监护,另外 8 人主修心血管外科。两轮问卷调查的有效回收率分别为 100%和 85.71%,专家熟悉程度分别为 0.81 和 0.80,判断系数分别为 0.94 和 0.92。专家权威系数均为 0.86。两轮调查中,重要性和可行性项目的变异系数分别为 0.13 至 0.32 和 0.11 至 0.32,0.06 至 0.26 和 0.06 至 0.35。两轮咨询中,重要性和可行性的 Kendall's W 分别为 0.264 和 0.162,以及 0.258 和 0.144,均有统计学意义(所有 P 均小于 0.05)。经过两轮专家会诊,综合评价和筛选,最终建立了心肺旁路心脏手术后患者高氧血症危险因素评估表,包括一般资料、既往史、手术相关资料和术后资料等4个维度23个项目:基于德尔菲法的心肺搭桥术后患者高氧血症风险因素评估表具有较高的科学性和可行性,可为临床评估此类患者的高氧血症风险提供参考。
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[Construction of risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery].

Objective: To construct Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery based on Delphi method, providing a basis for early prediction and assessment of the risk of hyperoxemia in patients after cardiac surgery.

Methods: A research team was established. Based on the characteristics of extracorporeal circulation cardiac surgery, the Chinese and English literature published by each database until October 2022 was retrieved and the opinions of relevant professional clinicians were combined to screen the risk factors of hyperoxemia in patients after cardiopulmonary bypass heart surgery, and the preliminary draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery was drawn up. The Delphi method was used to conduct two rounds of expert letter consultation to supplement and improve the initial draft and finally established the final draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery.

Results: The preliminary draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery was constructed according to the literature review and the opinions of relevant professional clinicians, which contained 4 dimensions and 21 items. A total of 14 experts were consulted by letter, including 5 senior titles and 9 associate senior titles. Six of them major in critical care and the other eight major in cardiovascular surgery. The effective response rates for the two rounds of questionnaire surveys were 100% and 85.71%, expert familiarity levels were 0.81 and 0.80, judgment coefficients were 0.94 and 0.92, respectively. Expert authority coefficients were both 0.86. Coefficients of variation for the importance and feasibility items in the two rounds ranged from 0.13 to 0.32 and 0.11 to 0.32, 0.06 to 0.26 and 0.06 to 0.35, respectively. The Kendall's W for importance and feasibility in the two rounds were 0.264 and 0.162, and 0.258 and 0.144 respectively, indicating statistically significant (all P < 0.05). After two rounds of expert consultations, a comprehensive evaluation and selection process resulted in the final establishment of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery, consisting of 4 dimensions and 23 items, which included general data, past history, operation-related data and postoperative data.

Conclusions: The Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery based on the Delphi method is highly scientific and feasible, which can provide reference for clinical assessments of the risk of hyperoxemia in such patients.

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来源期刊
Zhonghua wei zhong bing ji jiu yi xue
Zhonghua wei zhong bing ji jiu yi xue Medicine-Critical Care and Intensive Care Medicine
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1.00
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发文量
42
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