急性胰腺炎患者早期液体复苏护理管理方案的构建：一项中国的德尔菲研究
Construction of a nursing management program for early fluid resuscitation in patients with acute pancreatitis: a Delphi study in China.
作者信息
He Fang, Zhang Xiaohong, Liu Jiao, Mo Shaojian, Zhang Lei, Fu Xifeng, Tian Yanzhang, Gao Fei, Liu Yan
机构信息
General Surgery Department, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, 99 Longcheng street, Taiyuan, 030032, Shanxi province, China.
Nursing Department, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
出版信息
BMC Nurs. 2025 Jan 9;24(1):28. doi: 10.1186/s12912-025-02689-7.
AIM AND OBJECTIVES
To construct a set of scientific and feasible nursing management protocols for early fluid resuscitation in acute pancreatitis (AP) patients that can be used to guide clinical practice and enhance the treatment efficacy in these patients.
BACKGROUND
Fluid resuscitation is a key means of early treatment for AP patients and has become a clinical consensus. Nurses are important practitioners of fluid resuscitation, and there is a lack of specific enforceable nursing management programs.
METHODS
Through literature research, on-site research, semi-structured interviews, and other preliminary preparations of the first draft of the nursing management program for early fluid resuscitation in acute pancreatitis, the Delphi method was used to conduct two rounds of correspondence with medical and nursing experts, and then statistically analyzed.
RESULTS
Fifteen and 14 questionnaires were distributed in two rounds, respectively, and 15 and 14 questionnaires were recovered, respectively. The positive coefficient of experts was 100%, the authority coefficient was 0.970 and 0.975, respectively; the coefficient of variation coefficient was 0.05-0.21 and 0.00-0.20, respectively; the expert coordination coefficients of all levels of indices in this study are 0.166-0.335 and 0.189-0.364, respectively. The P values of the first, second, and third level indices are < 0.05 according to the test of Kendall's harmony coefficient. A total of 5 primary indicators, 11 secondary indicators, and 36 tertiary indicators were used to construct the Nursing Management Program for Early Fluid Resuscitation in Acute Pancreatitis.
CONCLUSIONS
The constructed nursing management plan for early fluid resuscitation in acute pancreatitis patients puts forward clear requirements and standards for nursing care in the early stage of AP treatment. This plan is scientific, represent good clinical practice, are feasible for nurses to follow, and construct a standardized protocol for the management of early fluid resuscitation in patients with acute pancreatitis.
目的与目标
构建一套科学可行的急性胰腺炎（AP）患者早期液体复苏护理管理方案，用于指导临床实践并提高这些患者的治疗效果。
背景
液体复苏是AP患者早期治疗的关键手段，已成为临床共识。护士是液体复苏的重要实施者，但缺乏具体可执行的护理管理方案。
方法
通过文献研究、现场调研、半结构化访谈等对急性胰腺炎早期液体复苏护理管理方案初稿进行前期准备，采用德尔菲法与医疗护理专家进行两轮函询，然后进行统计分析。
结果
两轮分别发放问卷15份和14份，回收问卷分别为15份和14份。专家积极系数均为100%，权威系数分别为0.970和0.975；变异系数分别为0.05 - 0.21和0.00 - 0.20；本研究各级指标的专家协调系数分别为0.166 - 0.335和0.189 - 0.364。根据肯德尔和谐系数检验，一级、二级和三级指标的P值均<0.05。共采用5项一级指标、11项二级指标和36项三级指标构建急性胰腺炎早期液体复苏护理管理方案。
结论
构建的急性胰腺炎患者早期液体复苏护理管理方案对AP治疗早期的护理提出了明确要求和标准。该方案科学，具有良好的临床实用性，护士可遵循，构建了急性胰腺炎患者早期液体复苏管理的标准化方案。
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