Abstract:

Objective To search and evaluate the relevant evidence of blood purification and anticoagulant management of perioperative liver transplantation patients，and to summarize the best evidence，so as to provide evidence-based evidence for clinical blood purification and anticoagulant management practice. Methods Evidence-based questions were determined. Systematic search was conducted on relevant domestic and foreign databases and websites for clinical decisions，guidelines，evidence summaries，system evaluations，and expert consensuses related to blood purification anticoagulation management. The retrieval period is from the establishment to May 2，2023. Literature screening，quality evaluation and evidence summary were conducted by 2 researchers. Results A total of 17 articles were included，including 2 clinical decisions，3 guidelines，2 evidence summaries，4 systematic evaluations and 6 expert consensuses. 24 pieces of best evidence were summarized from 6 dimensions，including coagulation function evaluation，anticoagulant strategy，mode selection，vascular access，standardized operation implementation points and personnel organization management. Conclusion The best evidence was summarized in the study on perioperative blood purification and anticoagulant management of liver transplantation，which can provide evidence-based basis for clinical medical staff to implement anticoagulant management. However，it is necessary to further carry out evidence-based practice of perioperative blood purification and anticoagulant management of liver transplantation to verify its anticoagulation effect and nursing safety in clinical practice.

Key words: Liver Transplantation, Perioperative Period, Blood Purification, Anticoagulant Management, Evidence Summary, Evidence-Based Nursing

摘要：

目的 检索、提取肝移植围手术期患者血液净化抗凝管理的相关证据，并对最佳证据进行汇总，为临床血液净化抗凝管理实践提供循证依据。方法 确定循证问题，系统检索国内外数据库及相关网站中关于血液净化抗凝管理相关的临床决策、指南、证据总结、系统评价及专家共识。检索时限为建库至2023年5月2日。由2名研究人员进行文献筛选、质量评价及证据汇总。结果 共纳入文献17篇，包括临床决策2篇、指南3篇、证据总结2篇、4篇系统评价及6篇专家共识。从凝血功能评估、抗凝策略选择、模式选择、血管通路选择与观察、标准化操作实施及人员组织管理等6个方面进行证据总结，最终汇总24条最佳证据。结论 该研究总结了肝移植围手术期患者血液净化抗凝管理的最佳证据，可为临床实施抗凝管理提供循证依据，但在临床实践中需进一步开展循证实践，验证其对提高血液净化患者的抗凝效果，确保护理安全。

关键词: 肝移植术, 围手术期, 血液净化, 抗凝管理, 证据总结, 循证护理学