Objective To evaluate pain of critical patients by Critical-Care Pain Observation Tool ( CPOT) comprehensively in order to provide evidences in choosing pain assessment tool for critically patients. Methods We performed PubMed, MEDLINE and CNKI for randomized controlled trial, quasi-experimental studies and cohort studies which kind of articles applied CPOT to assess pain in ICU. Results There was no statistical difference in the CPOT scores before nociceptive between conscious and unconscious patients ( P=0.06), while significant difference for conscious (P <0. 01) and unconscious (P <0. 01) patients existed between before and during nociceptive for discriminant analysis. That was pain could be noticed by the CPOT no matter whether patients were conscious or not. No significant differences existed in the score of the CPOT and self-report for communicative critically ill patients (P=0. 06) for validity analysis, which means the socore of CPOT could instead of pain compliment from patients theoretically. Conclusions We hold the view that behavioral score is as a cue to find pain. What we should do next step is expanding samples to validate whether CPOT score could instead of self-report score of patients.%目的：评价重症监护疼痛观察工具( CPOT)评估重症监护患者疼痛的测量学特性,为临床上选择重症监护患者疼痛评估的工具提供证据。方法计算机检索MEDLINE、Springer、Elsevier,中国知网、维普中关于用CPOT评估重症监护患者疼痛的实验或类实验的研究。结果对提供的相关数据进行分析,最终确定8篇符合要求的文献,根据最终提取的数据对量表的判别效度和效标效度进行分析。结果显示,判别效度,在休息状态下,有交流能力患者和无交流能力患者的CPOT得分差异无统计学意义(P=0.06),在疼痛刺激前、中,有交流能和无交流能力患者的CPOT得分差异有统计学意义(P<0.01)。即无论患者意识如何,CPOT均能有效地发现患者的疼痛；效标效度能交流患者的CPOT得分与主诉得分差异无统计学意义(P=0.06),即理论上,CPOT得分可代替患者的主诉的疼痛得分。结论 CPOT具有敏感的判别效度和良好的效标效度,能有效地发现疼痛存在与否。但能不能表示疼痛的程度,用于探索镇静镇痛药物使用剂量的标准还需进行进一步大样本、高质量的研究。
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