儿童压力性损伤风险评估工具的系统评价

Systematic evaluation of risk assessment tools for stress injury in children

目的对儿童压力性损伤风险评估工具进行系统评价。方法计算机检索PubMed、EMbase、CINAHL、Web of Science核心合集、CNKI、WanFang Data并手动检索部分文献的参考文献。2名研究者独立筛选文献、提取资料、对纳入文献进行质量评价,采用MetaDiSc 1.4软件进行Meta分析。结果共纳入10篇文章,8篇关于Braden-Q并进行Meta分析,合并后的灵敏度为0.72(95%CI:0.67~0.77),异质性92.7%(χ^(2)=96.35,P<0.001);特异度0.33(95%CI:0.31~0.36),异质性95.0%(χ^(2)=140.77,P<0.001);2篇关于NSRAS进行Meta分析,合并后的灵敏度为0.62(95%CI:0.54~0.69),异质性88.3%(χ^(2)=8.53,P<0.01);特异度为0.04(95%CI:0.02~0.06),异质性89.1%(χ^(2)=9.16,P<0.01)。1篇关于N/I Braden-Q灵敏度0.75,特异度0.74;1篇关于Glamorgan儿童压疮风险评估量表灵敏度1,特异度0.50。结论Braden-Q量表敏感度较好,更适用于普通儿科病房;对于新生儿压力性损伤评估工具目前还需进一步研究构建出适合我国临床的信效度较好的评估工具。

Objective To evaluate the risk assessment tools of stress injury in children.Methods Computer retrieval of PubMed,EMbase,CINAHL,core collection of Web of Science,CNKI,WanFang Data,and manual retrieval of some references.Two researchers independently screened the literature,extracted the data,and evaluated the quality of the included literature.MetaDiSc 1.4 software was used for meta-analysis.Results 10 articles were included,8 were about braden-q and meta-analysis was performed.The combined sensitivity was 0.72(95%CI:0.67~0.77),and the heterogeneity was 92.7%(χ^(2)=96.35,P<0.001).Specificity 0.33(95%CI:0.31~0.36),heterogeneity 95.0%(χ^(2)=140.77,P<0.001);Meta-analysis of NSRAS was performed in 2 articles,the combined sensitivity was 0.62(95%CI:0.54~0.69),and the heterogeneity was 88.3%(χ^(2)=8.53,P<0.01).The specificity was 0.04(95%CI:0.02~0.06),and the heterogeneity was 89.1%(χ^(2)=9.16,P<0.01).The sensitivity and specificity of N/I Braden-Q were 0.75 and 0.74 respectively.1 paper on the Glamorgan risk assessment scale for children with pressure ulcers:sensitivity 1,specificity 0.50.Conclusion The Braden-Q scale is more sensitive and suitable for general pediatric ward.At present,it is necessary to further study and construct a reliable and valid assessment tool for neonatal stress injury.