腹部创伤患者肠内营养喂养不耐受预警评估指标体系的构建

目的 构建腹部创伤患者喂养不耐受预警评估指标体系,为早期识别腹部创伤患者喂养不耐受风险提供参考。方法 基于循证,结合临床护理实践,采用德尔菲专家咨询法对16名专家进行2轮专家咨询,并对调查数据进行统计分析,最终确定方案。结果 专家的积极性分别为94%、100%;专家权威系数为0.906;2轮重要性及准确性的变异系数分别为0~0.265、0~0.255及0.084~0.250、0.068~0.178,肯德尔协调系数差异有统计学意义。最终形成患者基本状况、实验室指标、临床治疗措施、临床用药以及肠内营养相关因素5个维度,32个条目。结论 构建的腹部创伤患者喂养不耐受评估预警指标内容较为全面,具有科学性,临床实用性强,可为临床早期识别腹部创伤患者喂养不耐受风险提供参考。

Construction of Early Warning and Assessment Index System of Enteral Nutrition Intolerance for Patients with Abdominal Trauma

Objective To construct an early warning and assessment index system of feeding intolerance in patients with abdominal trauma, and to provide reference for early identification of feeding intolerance in patients with abdominal trauma. Methods In this evidence-based study, Delphi method was adopted in 16 experts for two rounds of consultation. The initial index system was constructed after data analysis. Results The positive coefficient of experts was 94% and 100% respectively; the authority coefficient 0.906, and the coefficients of variation of importance and accuracy of the second round were 0~0.265, 0~0.255 and 0.084~0.250,0.068~0.178 respectively. There were significant differences in Kendall’s concordance coefficient. The final system consisted of 32 items in 5 domain including general information of the patients, laboratory indicators, clinical treatment measures, clinical medication and factors related to enteral nutrition. Conclusion Being scientific, practical and comprehensive, the constructed early warning and assessment index system in the study provides reference for early clinical identification of the risk of feeding intolerance in patients with abdominal trauma.