经桡动脉穿刺冠状动脉介入治疗术肢管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.13.006

摘要/Abstract

摘要：

目的检索、评价及整合经桡动脉冠状动脉介入治疗术肢管理的最佳证据,为临床实践提供循证证据支持。方法应用循证方法,按照“6S”证据金字塔模型检索相关文献,检索时限为建库至2021年6月。由研究小组成员独立对各类文献进行质量评价,对符合标准的文献进行资料提取,并对各项证据进行分级判定。结果共纳入11篇文献,其中指南3篇,系统评价6篇,专家共识2篇。最终总结了21条经桡动脉冠状动脉介入治疗术肢管理的最佳证据,包括术前准备及评估、术后交接及观察、术后压迫与减压、活动时机与方式4个证据主题。结论该研究为经桡动脉冠状动脉介入治疗术肢管理提供了最佳证据,在证据转化时,应结合医院特点和临床情景,选择最佳证据,以改善桡动脉穿刺术肢围手术期的护理质量,提高患者的舒适度和安全性。

关键词: 经皮冠状动脉介入治疗, 经桡动脉, 围手术期护理, 循证护理学

Abstract:

Objective The best evidence on the limb management of transradial coronary intervention was retrieved,evaluated and integrated to provide evidence-based support for clinical practice. Methods By an evidence-based approach,the literature was searched according to the ‘6S’ pyramid of evidence model,with a timeframe of the database establishment to June 2021. Research team members independently evaluated the quality of the various types of the literature,extracted information that met the criteria,and graded each piece of evidence. Results A total of 11 papers were involved,including 3 guidelines,6 systematic reviews and 2 expert consensuses. The final summary of 21 pieces of best evidence on the management of the limb of transradial coronary intervention covers 4 topics,including preoperative preparation and assessment,postoperative handover and observation,postoperative compression and decompression,activity occasion and patterns. Conclusion This study provides the best evidence for the limb management of the transradial coronary intervention. When translating the evidence,the best evidence should be selected in relation to hospital characteristics and clinical scenarios,in order to improve the quality of perioperative care of the radial artery puncture limb and enhance the comfort and safety of patients.

Key words: Percutaneous Coronary Intervention, Transradial Intervention, Perioperative Nursing, Evidence-Based Nursing

谭钧旸, 马芳, 胡秋兰, 周航, 朱政, 马雪芩, 白阳娟. 经桡动脉穿刺冠状动脉介入治疗术肢管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(13): 1572-1578.

TAN Junyang, MA Fang, HU Qiulan, ZHOU Hang, ZHU Zheng, MA Xueqin, BAI Yangjuan. Evidence summary of limb management in transradial coronary intervention[J]. Chinese Journal of Nursing, 2022, 57(13): 1572-1578.

图/表 6

图1 文献检索及筛选流程注：sinoMED数据库为中国生物医学文献数据库;ACC为美国心血管学会;AHA为美国心脏病协会;ESC为欧洲心脏病协会;JBI为澳大利亚乔安娜布里格斯研究所;SIGN为苏格兰院际指南网;PCI为经皮冠状动脉介入治疗。

Figure 1 Literature retrieval and screening flow chart

表1 纳入文献的一般情况（n=11）

Table 1 General characteristics included in the literature（n=11）

表2 指南的质量评价结果（n=3）

Table 2 Quality evaluation results of guidelines（n=3）

表3 系统评价的质量评价结果（n=6）

Table 3 Results of quality evaluation of systematic review（n=6）

表4 专家共识的质量评价结果（n=2）

Table 4 Results of quality evaluation of the expert consensus（n=2）

表5 经桡动脉冠状动脉介入治疗术肢管理最佳证据总结

Table 5 Evidence summary for limb management after transradial coronary intervention

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