ICU经口气管插管患者口渴管理的证据总结

doi:10.3761/j.issn.0254-1769.2023.14.012

摘要/Abstract

摘要：

目的提取、评价和总结ICU经口气管插管患者口渴管理的相关证据，为医护人员的科学管理提供依据。方法系统检索BMJ Best Practice、CINAHL、Cochrane Library、Clinical Trials、Embase、PubMed、UpToDate、Web of Science、国际指南协作网、美国国立指南数据库、英国国家卫生与临床优化研究所网站、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、加拿大安大略省注册护士协会网站、苏格兰校际指南网、中国知网、中国生物医学文献数据库、万方数据库、维普数据库、医脉通等数据库或网站中关于ICU经口气管插管患者口渴管理的证据，包括临床决策、证据总结、指南、推荐实践、专家共识、系统评价和随机对照试验等，检索时限为建库至2022年11月20日。由2名经过循证护理培训的研究者独立进行文献的质量评价，并结合专家建议对证据进行提取和汇总。结果共纳入17篇文献，包括4篇临床决策、1篇证据总结、4篇系统评价、8篇随机对照试验。总结出26条关于ICU经口气管插管患者口渴管理的最佳证据，包括危险因素识别、口渴的评估、口渴的干预和效果评价4个方面。结论该研究总结的最佳证据可为临床医护人员管理ICU经口气管插管患者的口渴症状提供循证依据。在应用证据时，医护人员要结合患者的意愿和具体的临床情境，正确运用证据，解决患者的口渴问题。

关键词: 重症监护病房, 经口气管插管, 口渴, 证据总结, 循证护理学

Abstract:

Objective To extract，evaluate and summarize the relevant evidence of thirst management of patients with oral tracheal intubation in ICU，and to provide evidence bases for medical staff for scientific management. Methods The BMJ Best Practice，CINAHL，Cochrane Library，Clinical Trials，Embase，PubMed，UpToDate，Web of Science，Guidelines International Network（GIN），National Guideline Clearinghouse（NGC），National Institute for Health and Clinical Excellence（NICE），Joanna Briggs Institute（JBI），Registered Nurses’ Association of Ontario（RNAO），Scottish Intercollegiate Guidelines Network（SIGN），CNKI，SinoMed，Wan Fang database，VIP database and Yimaitong Guidelines Network were systematically searched for clinical decisions，evidence summaries，guidelines，recommended practices，expert consensuses，systematic reviews，and randomized controlled trials and the retrieval time limit is from the establishment of the database to November 20，2022. 2 researchers who were trained in evidence-based nursing independently evaluated the quality of the literature，and extracted and summarized the evidence in combination with expert suggestions. Results A total of 17 articles were included，including 4 clinical decisions，1 evidence summary，4 systematic reviews，and 8 randomized controlled trials. 26 pieces of best evidence were summarized on the management of thirst in ICU patients undergoing oral tracheal intubation，including 4 aspects：identification of risk factors for thirst，evaluation，intervention，and evaluation of the effectiveness of intervention measures. Conclusion The best evidence summarized in this study can provide evidence-based bases for clinical medical staff to manage the thirst symptoms of patients with oral tracheal intubation in ICU. When applying evidence，medical staff should correctly use the evidence in combination with the patient’s wishes and specific clinical situations to solve the patient’s thirst problem.

Key words: Intensive Care Units, Oral Tracheal Intubation, Thirsty, Evidence Summary, Evidence-Based Nursing

李营阳, 乔亚欣, 候琳琳, 蒋恩社, 景孟娟, 李黎明. ICU经口气管插管患者口渴管理的证据总结[J]. 中华护理杂志, 2023, 58(14): 1750-1757.

LI Yingyang, QIAO Yaxin, HOU Linlin, JIANG Enshe, JING Mengjuan, LI Liming. Evidence summary of thirst management in patients with oral tracheal intubation in ICU[J]. Chinese Journal of Nursing, 2023, 58(14): 1750-1757.

图/表 4

图1 文献筛选流程图

Figure 1 Flow chart of literature screening

表1 纳入文献的基本特征（n=17）

Table 1 Characteristics of included studies（n=17）

表2 纳入临床决策和证据总结的质量评价结果（n=5）

Table 2 Quality evaluation results of clinical decisions and evidence summaries（n=5）

表3 ICU经口气管插管患者口渴管理的证据总结

Table 3 Evidence summary of thirst management in ICU patients undergoing oral tracheal intubation

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