《围手术期术后胃肠动力评价规范》制订研究

A study on the establishment of the standard for evaluation of gastrointestinal motility in perioperative period

目的科学建立围手术期术后胃肠动力评价标准。方法应用文献研究、Delphi法、临床评价方法,制订科学规范的围手术期术后胃肠动力评价标准。①文献研究:检索中英文文献数据库,确定检索策略,形成文献数据库,进行文献梳理和分析总结。②Delphi法专家咨询:在文献研究基础上,采用Delphi法进行行业专家调研,筛选条目,形成围手术期术后胃肠动力评价规范初稿,专家组集中审议讨论争议的问题;通过5次专家咨询调研,形成围手术期术后胃肠动力评价规范终稿。③临床评价研究:在临床研究中应用上述评价规范,评价其适用性。④标准发布:在广东省质量监督局立项发布。结果①文献研究结果:围手术期术后胃肠功能恢复中主要症状恶心,呕吐,腹胀,腹痛,腹泻,排气,排便等;主要体征指标肠鸣音恢复情况;辅助检查指标胃电图,胃动素,胃泌素,血管活性肠肽等。②Delphi法研究结果:经过5轮全国专家问卷咨询,形成围手术期术后胃肠动力评价规范终稿,客观指标包括排气、排便、肠鸣音;主观指标包括腹胀痛,恶心,呕吐;评价规范量化加权后总分100分,良好80~100分;一般60~79分;差0~59分。③标准发布:已于2015年7月在广东省质量监督局发布(http://www.gdqts.gov.cn/zmhd/yjzj/201503/t20150310_103772.html)。结论本项目应用文献研究、Delphi法、临床研究方法,首次科学制订了行业内围手术期术后胃肠动力评价规范,为术后胃肠功能相关临床、研究等工作提供了科学评价的工具。

Objective To establish a scientific evaluation standard for gastrointestinal motility in perioperative period.Methods This approach was to through the application of literature search and research,Delphi method,clinical evaluation method to establish a scientific and standardized evaluation standard of postoperative gastrointestinal motility.First,literature research:search Chinese and English literature databases,determine retrieval strategies,form literature databases,sort out and analyze literature.Second,Delphi method expert consultation:on the basis of literature research,Delphi method was used to conduct peer expert research,select items,and form the first draft of the standard for postopera-tive gastrointestinal motility evaluation in the perioperative period.The expert group focused on discussing the controversial issues which through five times of expert consultation and research,the final draft of the standard for postoperative gastrointestinal motility evaluation in the perioperative period was formed.Third,clinical evaluation study:evaluate the applicability of the above evaluation criteria in clinical research.Fourth,standard release:it was approved and issued by Guangdong Provincial Bureau of Quality Supervision.Results First,literature research results:the main symptoms of gastrointestinal function recovery in perioperative period were nausea,vomiting,abdominal distention,abdominal pain,diar-rhea,exhaust,defecation,etc.Second,the results of Delphi method:after five rounds of national expert questionnaire consultation,the final draft of the standard for postoperative gastrointestinal motility evaluation was formed,and the objective indicators included exhaust,defecation and bowel sounds;the subjective indicators included abdominal distention,nausea and vomiting;the total score of the standard weighted evaluation was 100 points,good 80~100 points;general 60~79 points;difference 0~59 points.Third,standard release:issued in July 2015 by Guangdong Provincial Bureau of Quality supervision(http://www.gdqts.gov.cn/zmhd/yjzj/201503/t20150310_103772.html.Conclusion In this project,by using literature research,Delphi method and clinical research,a scientific evaluation standard of postoperative gastrointestinal motility in the industry has been established for the first time,which provides a scientific evaluation tool for clinical and research work related to postoperative gastrointestinal function.