毛细血管再充盈时间测量仪测量参数的可重复性与可信度研究

陈瑞; 黄晓敏; 谢志毅; 王仲

doi:10.13201/j.issn.1009-5918.2019.07.010

毛细血管再充盈时间测量仪测量参数的可重复性与可信度研究

- 1. 清华大学临床医学院(北京, 100084);
- 2. 清华大学临床医学院清华大学附属北京清华长庚医院全科医学

详细信息

通讯作者: 王仲,E-mail:Wangzhong523@vip.163.com

中图分类号: R312

收稿日期: 2019-04-16

Study on the repeatability and reliability of parameters of capillary refilling time measurement

- 1 Clinical Medical College, Tsinghua University, Beijing, 10084, China;
- 2 Beijing Tsinghua Changgung Hospital, Tsinghua University

More Information

Corresponding author: WANG Zhong, E-mail: Wangzhong523@vip.163.com

Received Date: 16 April 2019

摘要

摘要: 目的: 评价毛细血管再充盈时间测量仪测量S、a、b、CRT_auto、k值的可重复性与可信度。方法: 采用前瞻性观察性研究的方法,由2名接受培训后的测量者采用同一台毛细血管再充盈时间测量仪试验机对50例健康受试者的左手食指进行重复测量,测量者A测量1次,测量者B测量2次,分别采用组内相关系数(ICC)与信度系数(Cronbach's Alpha)评价2名测量者及同一测量者2次测量值的可重复性与可信度。结果: 本次研究共纳入2019年1月于北京清华长庚医院健康管理中心体检的50例健康成人,平均年龄(41.3±13.6)岁,其中男27例,女23例。测量者A、测量者B第1次测得的S、a、b、CRT_auto、k的ICC分别为0.008、0.501、0.888、0.863、0.899,Cronbach's Alpha分别为0.016、0.663、0.940、0.929、0.951。测量值B2次测得S、a、b、CRT_auto、k的ICC分别为0.070、0.649、0.848、0.857、0.916,Cronbach's Alpha分别为0.153、0.684、0.917、0.924、0.955。结论: 无论为不同观察者之间还是同一观察者不同观察次数之间,毛细血管再充盈时间测量仪试验机测量CRT_auto、b、k值的可重复性良好,而测量S、a值的可重复性与可信度不佳。
- 外周循环 /
- 血流动力学 /
- 毛细血管再充盈时间 /
- 可重复性 /
- 可信度
Abstract: Objective: To evaluate the repeatability and reliability of capillary refill time measuring instruments for S,a,b,CRT_autoand k values.Method: Using the method of prospective observational study,the left index finger of 50 healthy volunteers was measured repeatedly by two trained measurers using the same capillary refilling time measuring machine.Measurer A measured once and B measured twice.The repeatability and reliability of the measurements of two measurers and two measurements of the same measurer were evaluated by intraclass correlation coefficient and Cronbach's Alpha.Result: Fifty healthy adults from the health management center of Beijing Tsinghua Changgung Hospital in January 2019 were enrolled in this study,with an average age of 41.3 + 13.6 years,including 27 males and 23 females.The ICC of S,a,b,CRT_autoand k values measured by measurer A and B for the first time were 0.008,0.501,0.888,0.863 and 0.899,respectively.Cronbach's Alpha were 0.016,0.663,0.940,0.929 and 0.951,respectively.The ICC values of S,a,b,CRT_autoand k values in the two measurements by measurer B were 0.070,0.649,0.848,0.857 and 0.916 respectively,and Cronbach's Alpha were0.153,0.684,0.917,0.924 and 0.955 respectively.Conclusion: No matter between different observers or different times observed by unified observers,the repeatability of CRT_auto,b and k values measured by capillary refill time measuring machine is good,but the repeatability and reliability of S and a values are unsatisfactory.
- peripheral circulation /
- hemodynamics /
- capillary refill time /
- repeatability /
- reliability

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参考文献(19)

[1]	Edul VS,Enrico C,Laviolle B,et al.Quantitative assessment of the microcirculation in healthy volunteers and in patients with septic shock[J].Crit Care Med,2012,40:1443-1448.
[2]	Tachon G,Harrois A,Tanaka S,et al.Microcirculatory alterations in traumatic hemorrhagic shock[J].Crit Care Med,2014,42:1433-1441.
[3]	den Uil CA,Lagrand WK,van der Ent M,et al.Conventional hemodynamic resuscitation may fail to optimize tissue perfusion:an observational study on the effects of dobutamine,enoximone,and norepinephrine in patients with acute myocardial infarction complicated by cardiogenic shock[J].PLoS One,2014,9:e103978.
[4]	刘大为,王小亭,张宏民,等.重症血流动力学治疗-北京共识[J].中华内科杂志,2015,54(3):248-271.
[5]	Lima A,van Genderen ME,van Bommel J,et al.Nitroglycerin reverts clinical manifestations of poor peripheral perfusion in patients with circulatory shock[J],Crit Care,2014,18(3):R126.
[6]	Lima A,Bakker J.Clinical assessment of peripheral circulation[J].Curr Opin Crit Care,2015,21(3):226-231.
[7]	Anderson B,Kelly AM,Kerr D,et al.Capillary refill time in adults has poor inter-observer agreement[J].Hong Kong J Emerg Med,2008,15:71-74.
[8]	Pickard A,Karlen W,Ansermino MJ.Capillary refill time:is it still a useful clinical sign?[J].Anast Analg,2011,113:120-123.
[9]	Mouncey PR,Osborn TM,Power GS,et al.ProMISe Trial Investigators:Trial of early,goal-directed resuscitation for septic shock[J].N Engl J Med,2015,372:1301-1311.
[10]	Ince C,Guerci P.Why and when the microcirculation becomes disassociated from the macrocirculation[J].Intensive Care Med,2016,42(10):1645-1646.
[11]	Cecconi M,De Backer D,Antonelli M,et al.Consensus on circulatory shock and hemodynamic monitoring-Task force of the European Society of Intensive Care Medicine[J].Intensive Care Med,2014,40:1795-1815.
[12]	于学忠,陆一鸣,王仲,等.急性循环衰竭中国急诊临床实践专家共识[J].中华急诊医学杂志,2016,25(2):143-149.
[13]	Miyagatani Y,Yukioka T,Ohta S,et al.Vascular tone in patients with hemorrhagic shock[J].J Trauma,1999,47:282-287.
[14]	Chien LC,Lu KJ,Wo CC,et al.Hemodynamic patterns preceding circulatory deterioration and death after trauma[J].J Trauma,2007,62:928-932.
[15]	Bateman RM,Sharpe MD,Jagger JE,et al.Sepsis impairs microvascular auto-regulation and delays capillary response within hypoxic capillaries[J].Crit Care,2015,19:389.
[16]	陈瑞,谢志毅,王仲.毛细血管再充盈时间的概念梳理及其在急重症患者外周循环监测中的应用新进展[J].中华急诊医学杂志,2018,27(9):1062-1066.
[17]	陈瑞,陈晔,谷源涛,等.基于近红外光谱与光电容积脉搏波技术的毛细血管再充盈时间测量仪的设计与开发[J].中国医疗设备,2019,34(2):28-30.
[18]	Brown LH,Prasad NH,Whitley TW.Adverse lighting condition effects on the assessment of capillary refill[J].Am J Emerg Med,1994,12:46-47.
[19]	Lewin J,Maconochie I.Capillary refill time in adults[J].Emerg Med J,2008,25(6):325-326.