成人重症患者床旁超声引导鼻肠管置入的证据总结

doi:10.3761/j.issn.0254-1769.2023.08.014

摘要/Abstract

摘要：

目的检索、评价并总结成人重症患者床旁超声引导鼻肠管置入的最佳证据，为完善超声引导鼻肠管置入规范提供依据。方法计算机检索UpToDate、BMJ Best Practice、全球各指南网站、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、Cochrane Library等中英文相关数据库以及重症医学、营养协会网站关于成人重症患者床旁超声引导鼻肠管置入的相关文献，包括临床指南、专家共识、团体标准、临床决策、证据总结、系统评价等。检索时限为建库至2022年6月。由2名循证护理研究者对文献质量进行评价，并结合临床情境，提取相关证据。结果共纳入22篇文献。其中指南5篇，专家共识6篇，团体标准1篇，临床决策2篇，证据总结3篇，系统评价5篇。从临床场景、评估、准备、置管要点、护理等5个方面汇总了26条证据。结论该研究总结了成人重症患者床旁超声引导鼻肠管置入的最佳证据，为床旁开展超声引导鼻肠管置入提供借鉴，保证患者安全。

关键词: 超声检查, 重症患者, 鼻肠管, 幽门窦, 循证护理学

Abstract:

Objective To evaluate and summarize the best evidence for ultrasound-guided nasointestinal tube placement in adult critically ill patients，and to provide references for clinical practice. Methods The relevant evidence of ultrasound-guided nasointestinal feeding tube placement in adult critically ill patients was systematically searched from domestic and foreign databases and websites，including guidelines，expert consensuses，clinical decision-making，evidence summaries and systematic reviews，and the search time limit is from the establishment of the databases to June，2022. There were 2 researchers who independently assessed the quality of the literature and identified the level of evidence. Results A total of 22 articles were included，including 5 guidelines，6 expert consensuses，1 group standard，2 clinical decision-making，3 evidence summaries and 5 systematic reviews. 26 pieces of evidence were summarized from 5 themes：clinical situation，assessment，preparation，key points of catheterization，and nursing essentials. Conclusion The best evidence of ultrasound-guided nasointestinal tube placement in adult critically ill patients was summarized to provide evidence-based references for the implementation of bedside ultrasound-guided nasointestinal feeding tube placement and ensure patient safety.

Key words: Ultrasonography, Critically Ill Patients, Nasointestinal Feeding Tube, Pyloric Antrum, Evidence-Based Nursing

孙建华, 罗红波, 李尊柱, 李奇, 李欣, 赵明曦, 马鸿鸣, 井杰, 刘金榜, 崔文博, 张青, 马玉芬, 王小亭. 成人重症患者床旁超声引导鼻肠管置入的证据总结[J]. 中华护理杂志, 2023, 58(8): 986-992.

SUN Jianhua, LUO Hongbo, LI Zunzhu, LI Qi, LI Xin, ZHAO Mingxi, MA Hongming, JING Jie, LIU Jinbang, CUI Wenbo, ZHANG Qing, MA Yufen, WANG Xiaoting. Evidence summary for ultrasound-guided nasointestinal feeding tube placement in adult critically ill patients[J]. Chinese Journal of Nursing, 2023, 58(8): 986-992.

图/表 4

图1 文献筛选流程

Figure 1 Flow chart of literature screening

表1 纳入文献的基本情况（n=22）

Table 1 Characteristics of included studies（n=22）

表2 纳入指南的方法学质量评价结果（n=5）

Table 2 Quality evaluation results of guidelines（n=5）

表3 成人重症患者超声引导鼻肠管置入的最佳证据总结

Table 3 Evidence summary for ultrasound-guided nasointestinal feeding tube placement in adult critically ill patients

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