肿瘤患者输液港相关性血栓预防及管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.05.005

摘要/Abstract

摘要：

目的检索、评价和整合肿瘤患者输液港相关性血栓预防及管理的相关证据,为临床实践提供参考。方法使用计算机检索中国知网、BMJ Best Practice、UpToDate、Cochrane Library、乔安娜布里格斯研究所循证卫生保健中心数据库、CINAHL、Embase、PubMed、中国临床指南文库、苏格兰院际指南网、美国国立指南库、美国输液护士协会网站、美国国家综合癌症网、美国临床肿瘤学会网站、欧洲肿瘤内科学会网站、安大略省注册护士协会网站中关于肿瘤患者输液港相关性血栓预防及管理的证据,包括指南、系统评价、证据总结、推荐实践及专家共识,检索时限为建库至2021年3月10日。结果共纳入12篇文献,包括指南4篇、系统评价5篇、证据总结1篇、专家共识2篇,从风险评估、导管置入与维护、血栓筛查与诊断、预防、管理与治疗、健康教育6个方面,共总结30条最佳证据。结论该研究总结了肿瘤患者输液港相关性血栓预防及管理的最佳证据。护士及护理管理者可结合临床情景及患者意愿选择并应用证据,以制订科学的肿瘤患者输液港相关性血栓预防及管理方案,提升护理质量。

关键词: 肿瘤, 输液港, 血栓栓塞, 预防, 管理, 证据总结, 循证护理

Abstract:

Objective To search,evaluate and integrate the relevant evidence on the prevention and management of port-related venous thromboembolism（VTE） in cancer patients,and to provide references for clinical practice. Methods We searched CNKI,the BMJ Best Practice,UpToDate,Cochrane Library,JBI Database,CINAHL,Embase,PubMed,China Guideline Clearinghouse（CGC）,Scottish Interhospital Guidelines Network（SIGN）,National Guideline Clearinghouse（NGC）,American Intravenous Nurses Society（INS）,National Comprehensive Cancer Network（NCCN）,American Society of Clinical Oncology（ASCO）,European Society for Medical Oncology（ESMO）,and Registered Nurses’ Association of Ontario （RNAO） for relevant guidelines,systematic reviews,evidence summaries,recommended practices,and expert consensuses. The retrieval period is from the inception of databases to March 10,2021. Results A total of 12 articles were enrolled,including 4 clinical practice guidelines,5 systematic reviews,1 evidence summary and 2 expert consensuses. Totally 30 pieces of best evidence were summarized from 6 aspects,namely VTE risk assessment,catheter placement and maintenance,screening and diagnosis,prevention,management and treatment and health education. Conclusion This study summarized the best evidence on the prevention and management of port-related VTE in cancer patients. Nurses and nursing managers can select and apply the evidence according to clinical situation and patients’ wishes,so as to form a scientific,evidence-based,cancer port-related VTE prevention and management scheme,and improve nursing quality.

Key words: Neoplasms, Implantable Venous Access Port, Thromboembolism, Prevention, Management, Evidence Summary, Evidence-Based Nursing

鲁佳, 谢开红, 陈文思, 陈肖敏. 肿瘤患者输液港相关性血栓预防及管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(5): 544-550.

LU Jia, XIE Kaihong, CHEN Wensi, CHEN Xiaomin. Evidence summary for the prevention and management of port-related venous thromboembolism in cancer patients[J]. Chinese Journal of Nursing, 2022, 57(5): 544-550.

图/表 4

表1 纳入文献的一般情况（n=12）

Table 1 Characteristics of included studies（n=12）

图1 文献筛选流程图

Figure 1 Literature screening flow chart

表2 纳入指南的质量评价结果

Table 2 Quality evaluation of guidelines

表3 肿瘤患者输液港相关性血栓预防及管理的最佳证据总结

Table 3 Summary of the best evidence for the prevention and management of port-related venous thromboembolism in cancer patients

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