成人ICU患者外周动脉导管留置与维护的最佳证据总结

doi:10.3761/j.issn.0254-1769.2020.04.023

摘要/Abstract

摘要： 目的检索、评价和总结成人ICU患者外周动脉导管留置与维护的最佳证据。方法系统检索加拿大安大略护理学会网站、英国国家临床优化研究所、苏格兰大学校际指南网、国际指南网、医脉通等指南网及PubMed、CINAHL、Embase、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、中国知网、万方等数据库内关于成人ICU患者动脉导管留置与维护相关的所有证据,包括临床决策、指南、推荐实践、证据总结、专家共识等。检索时限为建库至2019年9月。由3名研究人员对文献质量进行独立评价,结合专业人员的判断,对符合标准的文献进行资料提取。结果共纳入文献13篇,包括决策系统1篇,指南3篇,证据总结7篇,专家共识2篇,从教育及培训、导管选择、穿刺部位及辅助技术、导管标识、皮肤消毒及无菌技术、敷料选择及更换、传感器系统、压力监测系统、冲洗液、拔除时机10个方面汇总证据,共27条。结论本研究总结了成人ICU患者外周动脉导管留置与维护的最佳证据,可为外周动脉导管的规范化管理提供循证依据,旨在降低外周动脉导管相关并发症的发生,保证患者安全。

关键词: 成人, 危重症患者, 动脉置管, 循证护理

Abstract: Objective To retrieve,appraise and summarize the best evidence of the insertion and maintenance of peripheral arterial catheterization among adult ICU patients. Methods We searched literature from the Registered Nurses' Association of Ontario（RNAO）,National Institute for Health and Care Excellence（NICE）,Scottish Intercollegiate Guidelines Network（SIGN）,Guidelines International Network（GIN） and Chinese Medive etc.,coupled with database search including PubMed,CINAHL,Embase,UpToDate,Joanna Briggs Institute（JBI）,CNKI,WANFANG to collect relevant guidelines,evidence summaries,recommended practice,and expert consensuses. The timeframe of data search ran from the inception of the databases to September 2019. 3 researchers evaluated the quality of the literature independently. With the help of external experts,eligible literature was selected for analysis. Results Totally 13 articles were selected,including 1 clinical decision,3 guidelines,7 evidence summaries,and 2 expert consensuses. Finally,27 items of best evidence were synthesized into 10 categories including education & training,catheter selection,catheter insertion and auxiliary technology,catheter label,skin sterilization and aseptic technique,dressing selection and replacement,transducers,pressure monitoring system,flush solution and replacement time. Conclusion This study summarized the best evidence for insertion and maintenance of peripheral arterial catheterization,and added supplemental evidence to standardize the management of arterial catheter in clinical practice,which may reduce the incidence of catheter-related complications and ensure the security of patients.

Key words: Adult, Critically Illness Patient, Arterial Catheterization, Evidence-Based Nursing

王轶, 韩柳, 袁翠, 王芳, 王颖. 成人ICU患者外周动脉导管留置与维护的最佳证据总结[J]. 中华护理杂志, 2020, 55(4): 600-606.

WANG Yi, HAN Liu, YUAN Cui, WANG Fang, WANG Ying. Best evidence summary for peripheral arterial catheterization insertion and maintenance in adult ICU patients[J]. Chinese Journal of Nursing, 2020, 55(4): 600-606.

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