创伤骨科血糖异常患者围手术禁食期血糖监测方案的构建

Construction of blood sugar monitoring scheme during the perioperative fasting period of patients with orthopedic trauma and dysglycemia

目的初步构建创伤骨科血糖异常患者围手术禁食期血糖监测方案。方法2015年11月—2016年3月，本研究通过文献回顾、质性访谈形成初步监测方案，采用目的抽样法选取上海市10名从事临床医疗、护理及护理管理领域的专家，采用德尔菲法进行专家咨询。采用Excel和SPSS 19.0进行数据处理，采用Cronbach′s α系数测量问卷信度。结果构建的监测方案包括一级条目1项，二级条目8项，三级条目24项。德尔菲专家咨询结果显示，专家权威系数为0.91，变异系数在0-0.29，Kendall′s W系数为0.411（P＜0.01），两轮咨询表信度分别为0.816和0.798。结论构建了包含一级条目1项，二级条目8项，三级条目24项的创伤骨科血糖异常患者围手术禁食期血糖监测方案，为今后优化创伤骨科围术期异常血糖管理提供了依据。

Objective To construct blood sugar monitoring scheme during the perioperative fasting period of patients with orthopedic trauma and dysglycemia.Methods The literature review and qualitative interview methods were used to form the preliminary monitoring scheme from November 2015 to March 2016. Then through the purposive sampling method,10 experts working in clinical medicine,nursing and nursing management were selected from Shanghai. Delphi expert consultation was applied. Excel and SPSS 19.0 were used for data processing. Coefficient of Cronbach′s α was used to measure the reliability of questionnaire. Results The constructed monitoring scheme included one level-1 item,eight level-2 items and 24 level-3 items. The results of Delphi expert consultation showed that the coefficient of the expert authority was 0.91,the coefficient of variation was between 0 and 0.29,and the coefficient of Kendall′s W was 0.411 （P〈0.01）. The reliability of consultation table in two rounds were 0.816 and 0.798.Conclusions The blood sugar monitoring scheme during the perioperative fasting period of patients with orthopedic trauma and dysglycemia,including 1 level-1 item,8 level-2 items and 24 level-3 items,is constructed. It provids the basis for optimizing the dysglycemia management of patients with orthopedic trauma during perioperative fasting period in future.