肺移植术后患者液体管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.16.017

摘要/Abstract

摘要：

目的全面检索并评价肺移植术后患者液体管理的相关证据，并对最佳证据进行总结，为临床医护人员对肺移植术后患者的液体管理提供参考。方法按照6S证据模型，系统检索国内外数据库和网站关于肺移植术后患者液体管理的证据，包括指南、临床决策、系统评价、证据总结、专家共识以及相关高质量原始研究，检索时限为建库至2022年10月。由2名研究人员对文献质量进行评价，并对证据进行提取、评价与整合。结果共纳入文献10篇，包括指南1篇，临床决策1篇，专家共识2篇，系统评价1篇，队列研究2篇，类实验研究1篇，横断面调查1篇，随机对照试验研究1篇，汇总整理出22条最佳证据，涉及评估和监测指标、液体治疗原则、管理3个方面。结论该研究总结了肺移植术后患者液体管理的最佳证据，为开展护理实践提供循证依据，医护人员应充分结合临床情景，尽早识别液体容量状态变化，维持患者容量平衡，从而改善患者预后。

关键词: 肺移植, 证据总结, 循证护理学, 液体管理

Abstract:

Objective To comprehensively search，evaluate and summarize the best evidence of fluid management in patients after lung transplantation，so as to provide a reference for clinical medical and nursing staff. Methods According to the 6S evidence model，domestic and foreign databases and websites were systematically searched for evidence on fluid management of patients after lung transplantation，including guidelines，clinical decisions，systematic reviews，evidence summaries，expert consensuses and high-quality original research closely related to research. The search time period was from the establishment of the database to October 2022. There were 2 researchers who evaluated the quality of the literature and extracted，evaluated，and integrated the evidence. Results A total of 10 articles were involved，including 1 clinical guideline，1 clinical decision，2 expert consensuses，1 systematic review，2 cohort studies，1 quasi-experimental study，1 cross-sectional survey，and 1 randomized controlled experimental study，and 22 pieces of best evidence were summarized from 4 aspects，namely evaluation and monitoring indicators，principles of fluid therapy and management. Conclusion This study summarizes the best evidence for fluid management in patients after lung transplantation，and medical staff should manage the volume balance status of patients after lung transplantation through evidence-based methods to improve patient prognosis.

Key words: Lung Transplantation, Evidence-Based Nursing, Evidence Summary, Fluid Management

周海清, 宫慧, 谷如婷, 江婵玉, 谢靖, 杨萍萍, 王盼盼, 魏丽丽. 肺移植术后患者液体管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(16): 2020-2026.

ZHOU Haiqing, GONG Hui, GU Ruting, JIANG Chanyu, XIE Jing, YANG Pingping, WANG Panpan, WEI Lili. Evidence summary for fluid management in patients after lung transplantation[J]. Chinese Journal of Nursing, 2023, 58(16): 2020-2026.

图/表 5

图1 PubMed 检索策略

Figure 1 PubMed search strategy

图2 文献筛选流程

Figure 2 Flow chart of literature screening

表1 纳入文献的一般特征（n=10）

Table 1 General characteristics of the included literature（n=10）

表2 专家共识的质量评价结果（n=2）

Table 2 Quality evaluation results of expert consensuses（n=2）

表3 肺移植术后患者液体管理的最佳证据总结

Table 3 Summary of the best evidence for fluid management in patients after lung transplantation

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