患儿术后谵妄非药物管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2020.05.021

摘要/Abstract

摘要：

目的检索和总结患儿术后谵妄非药物管理的最佳证据,为提高医护人员对其的管理质量提供循证依据。方法计算机检索UpToDate、BMJ Best Practice、Cochrane Library、围手术期注册护士协会指南库、乔安娜布里格斯研究所循征卫生保健中心数据库、美国指南网、国际指南网、欧洲儿科麻醉协会网站、美国麻醉护士协会网站、英国国家卫生与临床优化研究所、美国重症护士协会网站、中国知网和中国生物医学文献数据库关于患儿术后谵妄非药物管理的证据,包括指南、临床决策、最佳实践、系统评价、证据总结、Meta分析、专家共识,检索时限为建库至2020年2月。结果共纳入9篇文献,包括临床决策3篇、指南3篇、系统评价3篇,从患儿术后谵妄高危因素的评估、术前非药物干预、术中非药物干预、术后非药物干预、质量管理5个方面共总结了20条最佳证据。结论儿科医护团队应该接受患儿术后谵妄非药物管理的相关培训,掌握患儿术后谵妄的高危因素,并根据临床实际情况,选择合适的非药物干预措施,预防患儿术后谵妄的发生,提高患儿术后安全。

关键词: 儿童, 术后谵妄, 非药物管理, 循证护理

Abstract:

Objective To search and retrieve the best evidence on non-pharmacological management in children who may develop postoperative delirium,and to provide evidence-based guidance for clinical practice.Methods We searched databases and websites from inception to February 2020,including Up to Date,BMJ Best Practice,Cochrane Library,the Association of perioperative Registered Nurses（AORN）,JBI（JBI Systematic Review/JBI Evidence Summary）,National Guideline Clearinghouse（NGC）,Guidelines International Network（GIN）,European Society of Anaesthesiology（ESA）,American Association of Nurse Anesthetists（AANA）,National Institute for Health and Care Excellence（NICE）,American Association of Critical-Care Nurses（AACN）,CNKI and CBM to collect the literature concerning guidelines,clinical decisions,best practices,system reviews,evidence summaries,Meta-analysis and expert consensuses on non-pharmacological management of children with postoperative delirium.Results A total of 9 articles were incorporated,including 3 clinical decisions,3 guidelines and 3 system reviews. A total of 20 pieces of best evidence including 5 aspects were summarized,namely assessment of high risk factors,preoperative interventions,intraoperative interventions,postoperative interventions and quality management.Conclusion Pediatric professionals should receive relevant training on non-pharmaceutical management skills on postoperative delirium in pediatric patients,master the high risk factors and implement non-pharmacological interventions based on the specific clinical situations,so as to prevent the incidence of postoperative delirium in children and improve their safety.

Key words: Children, Postoperative Delirium, Non-Pharmacological Intervention, Evidence-Based Nursing

王蒙蒙,温苑明,邓永芳,黄佩钰,刘佩珍. 患儿术后谵妄非药物管理的最佳证据总结[J]. 中华护理杂志, 2021, 56(5): 762-766.

WANG Mengmeng,WEN Yuanming,DENG Yongfang,HUANG Peiyu,LIU Peizhen. Summary of best evidence on non-pharmacological management in children with postoperative delirium[J]. Chinese Journal of Nursing, 2021, 56(5): 762-766.

图/表 3

表1 纳入文献的一般特征

Table 1 General characteristics of included literature

表2 指南各维度标准化百分比及2项综合评价结果

Table 2 Standardization percentage of each dimension and 2 comprehensive evaluation results

表3 患儿术后谵妄非药物管理最佳证据总结

Table 3 Summary of best evidence on non-pharmacological management in children with postoperative delirium

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