ICU患者深静脉血栓形成风险评估指标的初步研究

Primary research on indicators for deep venous thrombosis risk assessment in ICU patients

目的建立适用于ICU患者深静脉血栓形成的风险评估指标,为正确评估ICU患者深静脉血栓形成风险提供可操作的工具。方法在回顾文献基础上初步筛选风险评估指标44个,采用Delphi法对22名专家进行2轮函询,进一步筛选指标。结果2轮专家函询表回收率分别为72.73%和93.75%,权威系数分别为0.844和0.852,协调系数分别为0.207、0.277。初步确定了包含患者基本情况、患者疾病/外伤情况、患者治疗情况3个方面45个指标的ICU患者深静脉血栓形成风险的评估指标,指标重要性评分3.71～4.79分,变异系数0.0889～0.3245,权重系数0.0193～0.0248。结论初步确定的ICU患者深静脉血栓形成风险评估指标具有较高的可信度,但专家对个别指标的意见尚不集中,指标的信效度和可行性还需在临床研究中进一步检验。

Objective To initially establish indicators for deep venous thrombosis （DVT） risk assessment in ICU patients,and to pro- vide an operable tool to properly estimate the risk of DVT for ICU patients. Methods Totally,44 indicators were initially identified based on literature reviews, then 22 experts were consulted twice with the Delphi method for further screening the indicators. Re- suits In two rounds of surveys, expert response rates were 72.73 % for the first round, and 93.75 % for the second round; expert authority coefficients were 0. 844 for the first, and 0. 852 for the second round, and Kendall＇s coefficients of concordance were 0. 207, and 0. 277 respectively. A total of 45 indicators with high credibility were identified, being categorized into such three as- pects of patient＇s basic conditions, diseases/trauma history and treatment. The importance ratings of 45 indicators ranged from 3.71 to 4.79 points, the coefficients of variation ranged from 0. 0889 to 0. 3245 and the weights from 0. 0193 to 0. 0248. Conclusion The identified 45 indicators for deep venous thrombosis risk assessment in ICU patients enjoy high credibility. However, experts had different opions about some indicators. Therefore, further clinical study is needed to test the reliability,validity and feasibility of the indicators.