俯卧位通气患者眼部并发症护理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2024.08.014

摘要/Abstract

摘要：

目的检索、评价并整合ICU俯卧位通气患者眼部并发症护理的相关证据，为临床实践提供参考。方法系统检索国内外相关指南网站、专业协会网站及BMJ Best Practice、UpToDate、Cochrane Library、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库、PubMed、Web of Science、Science Direct、Embase、中国知网、万方数据库等关于ICU俯卧位通气患者眼部并发症护理的证据，文献类型包括临床实践指南、临床决策、证据总结、专家共识、团体标准、系统评价和范围审查，检索时限为2013年1月—2023年6月。指南由4名研究者独立进行质量评价，其余文献由2名研究者独立评价，对符合要求的文献提取证据并分级。结果共纳入文献15篇，包括6篇指南、2篇临床决策、2篇证据总结、3篇系统评价、1篇范围审查和1篇团体标准，从组织与培训、风险识别、眼部评估、眼部保护、体位管理、定期观察6个方面共总结了16条证据。结论该研究总结了ICU俯卧位通气患者眼部并发症护理的最佳证据，ICU医护人员应结合临床情境，选择有针对性的证据对俯卧位患者进行眼部保护，从而降低眼部并发症的发生率，提高患者生存质量。

关键词: 重症监护室, 俯卧位, 眼部并发症, 预防, 循证护理学

Abstract:

Objective To retrieve，evaluate and summarize the best evidence on the management of ocular complications in intensive care patients ventilated in prone position，and to provide references for clinical practice. Methods Evidence on management of ocular complications in intensive care patients ventilated in prone position was systemically retrieved in the guideline websites，professional association websites and databases，such as the BMJ Best Practice，UpToDate，Cochrane Library，Joanna Briggs Institute，PubMed，Web of Science，Science Direct，Embase，CNKI，Wanfang and other databases，including guidelines，clinical decisions，evidence summaries，expert consensuses，group standards，systematic reviews and scoping reviews，published from January 2013 to June 2023. The guidelines were individually evaluated by 4 researchers，and the remaining literature was individually evaluated by 2 researchers. The literature that met the criteria was extracted and graded. Results A total of 15 articles were involved，including 6 guidelines，2 clinical decisions，2 evidence summaries，3 systematic reviews，1 scoping review and 1 group standard. Finally，6 evidence topics and 16 pieces of best evidence were formed，including organization and training，risk identification，eye assessment，eye protection，position management and regular observation. Conclusion This study summarized the best evidence on the management of ocular complications in intensive care patients ventilated in prone position. In the application，the best evidence should be selected according to the clinical situation，so as to reduce the incidence of ocular complications and improve the quality of life of patients.

Key words: Intensive Care Unit, Prone Position, Ocular Complications, Prevention, Evidence-Based Nursing

郭凡, 王敏, 顾肖, 周英凤, 蒋玲, 黄琴, 程念开, 陈怡雷. 俯卧位通气患者眼部并发症护理的最佳证据总结[J]. 中华护理杂志, 2024, 59(8): 987-995.

GUO Fan, WANG Min, GU Xiao, ZHOU Yingfeng, JIANG Ling, HUANG Qin, CHENG Niankai, CHEN Yilei. Best evidence summary for the management of ocular complications in intensive care patients ventilated in prone position[J]. Chinese Journal of Nursing, 2024, 59(8): 987-995.

图/表 4

图1 文献筛选流程图注：GIN为国际指南协作网；AHRQ为美国卫生保健研究与质量机构；NICE为英国国家卫生与临床优化研究所；SIGN为苏格兰校际指南网；RNAO为加拿大安大略省注册护士学会；NSW-ACI为新南威尔士州临床创新机构；FICM为英国重症监护医学院；RCOphth为英国皇家眼科医学院；SFAR为法国麻醉与重症监护学会；JBI为乔安娜布里格斯研究所。

Figure 1 Flow chart of literature screening

表1 纳入文献的一般特征（n=15）

Table 1 General characteristics of included articles（n=15）

表2 临床实践指南的质量评价结果（n=6）

Table 2 Quality assessment of included guidelines（n=6）

表3 ICU俯卧位通气患者眼部并发症护理的最佳证据总结

Table 3 Best evidence summary for the management of ocular complications in intensive care patients ventilated in prone position

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