两种量表对NICU新生儿压力性损伤形成的预测效果

目的：比较新生儿皮肤风险评估量表（NSRAS）与新生儿/婴儿Braden Q量表（N/I Braden-Q量表）对NICU新生儿压力性损伤（PI）形成的预测效果。方法：采用方便抽样法，选取温州医科大学附属第二医院育英儿童医院NICU科室106例患儿作为研究对象，每天对患儿进行量表评分及皮肤检查，采用自制调查表进行资料收集，以患儿发生PI作为结局终点。结果：13例（12.3%）患儿发生PI，分布部位包括鼻部（8例）、后枕部（3例）、下唇（1例）及骶尾部（1例）。NSRAS入院当天评分、PI发生前24 h/住院中期评分、最高评分的Cronbach’s α系数为0.539、0.557、0.579，N/I Braden-Q量表三次评分的Cronbach’s α系数为0.559、0.568、0.679；NSRAS的ROC曲线下面积为0.539～0.737，N/I Braden-Q量表的ROC曲线下面积为0.725～0.875。结论：N/I Braden-Q量表预测效度高于NSRAS，更适用于预测NICU新生儿PI形成。

A comparison of predictive effect of two scales for the neonatal pressure injury on the neonatal intensive care unit

Objective: To compare the neonatal skin risk assessment scale (NSRAS) and neonatal/infant Braden Q scale (N/I Braden-Q scale) in predicting the formation of pressure injury (PI) in the NICU. Methods:A continuous convenient sample of 106 infants were included from a hospital of Zhejiang Province. Scale score and skin examination were performed on the newborns every day. A self-made questionnaire was used for data collection and the occurrence of PI was taken as the end point of the outcome. Results: PI developed in 13 neonates(12.3%), which distributed at nose (8 cases), posterior occipital (3 cases), underlip (1 case) and sacrococcygeal (1 case). The scores of Cronbach’s coefficient of NSRAS on the day of admission, 24 h before PI occurred/interim hospitalization and the highest day ranged from 0.539, 0.557, 0.579, while the Cronbach’s coefficient scores of N/I Braden-Q scale ranged from 0.559, 0.568, 0.679. The area under the ROC curve of NSRAS ranged from 0.539 to 0.737, and that of N/I Braden-Q scale ranged from 0.725 to 0.875. Conclusion: N/I Braden-Q scale has higher predictive validity than NSRAS, and is more suitable for predicting PI formation in NICU neonates.