断指再植术后血管危象预测评估表的编制

目的：本研究旨在编制断指再植术后血管危象预测评估表,快速、准确、有效的评估断指再植术后血管危象的高危人群,为断指再植术后血管危象高危人群的评估提供可靠工具。方法采用德尔菲法向相关领域数名专家进行两轮函询,筛选条目,确立断指再植术后血管危象预测评估表的初稿。便利抽取在南通大学附属医院手外科住院并且行断指再植术的患者60例进行预实验,采用t检验法、量表题项与总分的相关系数法、克伦巴赫α系数法、因子分析法进行评估表的项目分析及筛选。用探索性因素分析法进行建构效度检验,敏感性、特异性分析以及内部一致性信度克伦巴赫α系数等统计学指标验证评估表的信度、效度。结果本研究中,专家的权威程度Cr=(0.88+0.89)/2=0.88,为可接受的系数。项目分析中,年龄、性别、断离平面这3个条目的t值未达显著性,给予删除。采用因素分析法验证评估表的结构效度,分析结果与预测评估表的结构基本吻合,具有较好的结构效度。本预测评估表的内部一致性信度Cronbach's α系数为0.84,在0.70之上,信度理想。预测评估表的敏感性及特异性分别为0.87和0.82,在可接受范围内。结论该预测评估表共包括9个条目,结果显示具有较好的信度、效度,对于断指再植术后血管危象的预测评估具有较高的灵敏度和特异度,可作为断指再植术后血管危象高危人群的评估工具。

The creation of vascular crisis assessment scale after the replantation of severed fin-ger

Objective This study aimed to establish a evaluation scale to predict vascular crisis after replanta-tion of injured finger. And in this way the group of high risk can be fixed and predicted quickly, accurately and effec-tively. It can also provide reliable tool for evaluating the high-risk group after replantation of finger. Methods Two rounds of consulation to several experts in related field were conducted by the Delphi method and the items were select-ed. A primitive evaluation form of vascular crisis after replantation of severed finger was established. 60 patients from the Affiliated Hospital of Nantong University who were being treated after the replantation of severed finger were selected and given the pre-survey. Independent sample t-test, correlation coefficient, Cronbach's alpha coefficient and factor analysis method were adopted to analyze and select the items of the evaluation form. Exploratory factor analysis was used to exam-ine construction validity. The reliability and validity of the evaluation form was examined and analyzed by the indicators of sensitivity, specificity and Cronbach's alpha coefficient. Results In the study, the authority of experts Cr= (0. 88+0. 89) /2=0. 88 was acceptable. In the project analysis, the t values of age, gender and laceration plane were deleted because they did not achieve the conspicuousness. The factor analysis was used to examine the construct validity of the e-valuation form, and the analysis results generally align with the construction of the form, which showed a good construc-tion validity. The internal consistency reliability Cronbach's alpha coefficient was 0. 84, exceeding 0. 70, the reliability was ideal. The sensitivity and specificity were 0. 87 and 0. 82 respectively, which were within the acceptable range. Conclusions The table contains 9 items, and the results showed a good reliability and validity, and it has a high sensitivity and specificity for the evaluation of the vascular crisis after the replantation of severed finger. It can be used as the evaluation tools for the patients with the highest risk group of the vascular crisis after the replantation of se-vered finger.