CAJ | 학술논문

目的：探索采用简化COMFORT量表评估机械通气患儿镇静水平时，不同评价者之间以及与脑电双频指数(BIS)的一致性，从而确定其信度、效度和临床应用前景。方法以重症监护病房3~16岁接受机械通气和镇静治疗的患儿为研究对象，以简化COMFORT量表(不包括心率和血压)进行镇静分层评估，同时记录BIS监测数值。由4名专业医师独立完成评估，计算评估者相互之间Kappa值，分析简化COMFORT量表与BIS结果之间相关性。结果共纳入20例患儿，进行了70次评估。4名评分者相互之间的Kappa值为0.62~0.77(P<0.001)；简化COMFORT量表与BIS结果之间成正相关(r=0.53~0.61，P均<0.01)。结论简化COMFORT量表在不同的评价者以及与BIS之间均显示出较高的一致性，具有较好的信度和效度，可用于机械通气患儿镇静水平评估。
목적：탐색채용간화COMFORT량표평고궤계통기환인진정수평시，불동평개자지간이급여뇌전쌍빈지수(BIS)적일치성，종이학정기신도、효도화림상응용전경。방법이중증감호병방3~16세접수궤계통기화진정치료적환인위연구대상，이간화COMFORT량표(불포괄심솔화혈압)진행진정분층평고，동시기록BIS감측수치。유4명전업의사독립완성평고，계산평고자상호지간Kappa치，분석간화COMFORT량표여BIS결과지간상관성。결과공납입20례환인，진행료70차평고。4명평분자상호지간적Kappa치위0.62~0.77(P<0.001)；간화COMFORT량표여BIS결과지간성정상관(r=0.53~0.61，P균<0.01)。결론간화COMFORT량표재불동적평개자이급여BIS지간균현시출교고적일치성，구유교호적신도화효도，가용우궤계통기환인진정수평평고。
Objective To compare the scores from the simpliifed COMFORT scale with those from the bispectral index (BIS) and analyze the variation among different evaluators in children in an intensive care unit, and to investigate the reliability;validity of simpliifed COMFORT scale. Methods Twenty children between 3 and 16 years of ages on mechanical ventilation and sedation were simultaneously classiifed based on the BIS and the simpliifed COMFORT scale evaluated by 4 independent evalua-tors. The Kappa test was performed and the correlation between the two methods (Pearson correlation) was tested. Results In to-tal, 70 observations were performed on 20 patients. Based on the Kappa coefifcient, the agreement among evaluators ranged from 0.62 to 0.77 (P<0.001). There was a correlation between the BIS and the simpliifed COMFORT scale (r=0.53-0.61,P<0.01). Conclusions Due to the strong consistency between the independent evaluators and the correlation between the two methods, the reliability and validity of simpliifed COMFORT scale are preferable and simpliifed COMFORT scale is useful in classifying the level of sedation in children on mechanical ventilation.