CRRT患者CVC导管功能障碍的风险评估指标体系的构建

Construction of risk assessment index system for CVC dysfunction in CRRT patients

目的构建全面且具有针对性的连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)患者中心静脉导管(central venous catheter,CVC)导管功能障碍的风险评估指标体系。方法基于文献分析、德尔菲专家函询,确定CRRT患者CVC导管功能障碍的风险评估指标相关内容。遴选19名血液透析领域的专家,于2023年7—9月对其进行专家函询,根据专家意见与指标筛选标准,增删或修改相应指标,第2轮函询后专家意见趋于一致。结果本研究最终共有17位专家完成了2轮函询。2轮咨询中问卷的有效回收率分别为89.5%(17/19)、100.0%(19/19),专家权威系数分别为0.87、0.88,肯德尔和谐系数分别为0.131、0.138(P<0.05)。最终形成的风险评估指标体系包括7项一级指标、44项二级指标。结论本研究构建的CRRT患者CVC导管功能障碍的风险评估指标体系科学、可靠且实用,可为临床医护人员完善CRRT患者的导管风险管理提供参考与借鉴。

Objective To construct a comprehensive and targeted risk assessment index system for central venous catheter(CVC)dysfunction in patients undergoing continuous renal replacement therapy(CRRT).Methods The risk assessment indicators for CVC dysfunction in CRRT patients were determined based on literature review and Delphi expert consultation.From July to September 2023,19 experts in hemodialysis were selected for expert consultation.Based on expert opinions and screening criteria,corresponding indicators were added,deleted,or modified.After the second round of consultation,the expert opinions tended to be consistent.Results A total of 17 experts completed two rounds of consultation.In the two rounds of consultation,the effective response rates of the questionnaires were 89.5%(17/19)and 100.0%(19/19),respectively,and the expert authority coefficients were 0.87 and 0.88,respectively.The Kendall harmony coefficients were 0.131 and 0.138(P<0.05).The final risk assessment index system included seven primary indicators and 44 secondary indicators.Conclusions The risk assessment index system for CVC dysfunction in CRRT patients constructed is scientific,reliable,and practical,which can provide reference for clinical medical and nursing staff to improve catheter risk management in CRRT patients.