成人烧伤患者静脉血栓栓塞症预防的证据总结

doi:10.3761/j.issn.0254-1769.2023.11.016

摘要/Abstract

摘要：

目的评价并总结成人烧伤患者静脉血栓栓塞症预防的相关证据，为科学、规范地预防烧伤患者静脉血栓栓塞症提供依据。方法计算机检索UpToDate、国际指南协作网、英国国家卫生与临床优化研究所网站、苏格兰校际指南网、美国国家指南库、医脉通网站、世界卫生组织网站、国际烧伤协会网站、加拿大安大略注册护士协会网站、美国围手术期护士协会网站、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、Web of Science、EBSCO、Embase、CINAHL、Clinicalkey、PubMed、万方数据库、中国知网、中国生物医学文献服务系统中关于成人烧伤患者静脉血栓栓塞症预防和管理相关的临床决策、实践指南、系统评价、证据总结、专家共识、原始研究等，检索时限为建库至2022年7月。由2名研究者以互盲形式进行文献质量评价和资料提取。结果共纳入15篇文献，其中临床决策2篇、指南6篇、系统评价1篇、证据总结1篇、专家共识2篇、原始研究3篇。从风险评估、预防措施、文书记录、健康教育4个方面汇总28条最佳证据。结论该研究总结了成人烧伤患者静脉血栓栓塞症预防的最佳证据，可用性较强，医护人员可遵循最佳证据并综合考虑临床情境和患者意愿制订预防方案，促进烧伤患者静脉血栓栓塞症规范预防的循证护理实践。

关键词: 烧伤, 静脉血栓栓塞症, 预防, 循证护理学

Abstract:

Objective To evaluate and summarize the best evidence on preventing venous thromboembolism in adult burn patients，and provide references for clinical practice. Methods We retrieved all evidence on the prevention of venous thromboembolism in adult burn patients from databases and websites，including UpToDate，Guidelines International Network（GIN），National Institute for Health and Care Excellence（NICE），Scottish Intercollegiate Guide Network（SIGN），National Guideline Clearinghouse（NGC），Yimaitong，World Health Organization （WHO），International Society for Burn Injuries（ISBI），Registered Nurses Association of Ontario（RNAO），Association of periOperative Registered Nurses（AORN），Joanna Briggs Institute（JBI），Cochrane Library，Web of Science，EBSCO，Embase，CINAHL，Clinicalkey，PubMed，CNKI， CBM，and Wanfang. The retrieval period was from the inception of databases to July 31，2022. There were 2 researchers with evidence-based nursing backgrounds who assessed the quality of the literature and extracted the data independently. Results A total of 15 articles were incorporated，including 2 clinical decisions，6 guidelines，1 systematic review，1 evidence summary，2 expert consensus，and 3 original studies. A total of 28 pieces of best evidence were summarized from 4 aspects，including risk assessment，preventive measures，documentary records，and health education. Conclusion This study summarized the best evidence for thromboprophylaxis in adult burn patients. Clinical staff could comprehensively combine the clinical situation and patients’ wishes to form a prevention program for venous thromboembolism in adult burn patients based on the best evidence. It will promote the evidence-based nursing practice of standardized thromboprophylaxis in burn patients.

Key words: Burns, Venous Thromboembolism, Prevention, Evidence-Based Nursing

胡蛟, 卜平元, 李玲, 蒋洁琼, 李群, 王卫红, 陈炜. 成人烧伤患者静脉血栓栓塞症预防的证据总结[J]. 中华护理杂志, 2023, 58(11): 1381-1388.

HU Jiao, BU Pingyuan, LI Ling, JIANG Jieqiong, LI Qun, WANG Weihong, CHEN Wei. Evidence summary for prevention of venous thromboembolism in adult burn patients[J]. Chinese Journal of Nursing, 2023, 58(11): 1381-1388.

图/表 5

图1 PubMed数据库的检索策略

Figure 1 Search strategy of PubMed database

图2 文献筛选流程图

Figure 2 Flow chart of literature

表1 纳入文献的基本特征（n=15）

Table 1 Characteristics of included literature（n=15）

表2 纳入指南的方法学质量评价结果（n=6）

Table 2 Quality evaluation results of guidelines（n=6）

表3 成人烧伤患者静脉血栓栓塞症预防的最佳证据总结

Table 3 Evidence summary for prevention of venous thromboembolism in adult burn patients

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