迷你中长导管留置与维护的最佳证据总结

doi:10.3761/j.issn.0254-1769.2024.04.004

摘要/Abstract

摘要：

目的检索、评价并整合成人患者迷你中长导管留置与维护的最佳证据，为临床规范和安全使用迷你中长导管提供循证依据。方法系统检索UpToDate、BMJ Best Practice、国际指南协作网、美国国立指南库、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、英国国家卫生与临床优化研究所网站、美国疾病控制和预防中心网站、苏格兰学院间指南网、加拿大医学会临床实践指南文库、加拿大安大略省注册护士协会网站、美国静脉输液护士协会网站、Cochrane Library、PubMed、CINAHL、Embase、Web of Science、医脉通、中国知网、万方数据库、中国生物医学文献数据库中关于迷你中长导管留置与维护的相关指南、专家共识、证据总结、系统评价、Meta分析、最佳实践等，检索时限为2013年1月1日—2023年5月31日。由2名研究者独立对纳入的文献进行质量评价，采用乔安娜布里格斯研究所循证卫生保健中心证据预分级系统（2014版）对文献进行分级，并对提取的证据进行主题分类与汇总。结果共纳入10篇文献，包括6篇指南、2篇专家共识、2篇系统评价，从迷你中长导管适应证与禁忌证、导管留置、导管维护、导管拔除4个主题总结出20条最佳证据。结论该研究全面、科学地总结了迷你中长导管留置与维护的最佳证据，建议临床医护人员结合医疗情境和患者意愿等，遵从个体化原则进行证据转化，从而提高临床应用迷你中长导管的规范性和安全性。

关键词: 迷你中长导管, 留置, 维护, 证据总结, 循证护理学

Abstract:

Objective To search，evaluate，and summarize the best evidence of insertion and maintenance of mini-midline in adult patients，in order to provide a solid evidence-based foundation for establishing clinical standardized and safe utilization of mini-midline. Methods We systematically searched UpToDate，BMJ Best Practice，Guideline International Network，National Guideline Clearinghouse，Joanna Briggs Institute，National Institute for Health and Care Excellence，Centers for Disease Control and Prevention，Scottish Intercollegiate Guidelines Network，Canadian Medical Association：Clinical Practice Guideline，Registered Nurses’ Association of Ontario，Intravenous Nurses Society，Cochrane Library，PubMed，CINAHL，Embase，Web of Science，Yimaitong，China National Knowledge Infrastructure，Wanfang Database，and China Biomedical Literature Database. It includes clinical practice guidelines，expert consensuses，evidence summaries，systematic reviews，meta-analyses，and best practice on mini-midline insertion and maintenance. The search period covered January 2013 to May 2023. 2 researchers independently evaluated the literature quality and extracted the literature that met the standards. The evidence was graded using the JBI evidence pre-grading system（2014），and the extracted evidence was classified and summarized by themes. Results A total of 10 pieces of the literature were involved，including 6 guidelines，2 expert consensuses，and 2 systematic reviews. This study summarized 20 pieces of best evidence in relation to the following 4 themes：indications and contraindications for mini-midline，catheter insertion，catheter maintenance and catheter removal. Conclusion The study comprehensively and scientifically summarizes the best evidence regarding the insertion and maintenance of mini-midline. We recommend that clinical practitioners integrate this evidence into their practice，while considering individual patient preferences and medical contexts. This approach，in line with the principle of individualization，will contribute to enhancing the standardization and safety of mini-midline use in clinical settings.

Key words: Mini-Midline, Insertion, Maintenance, Evidence Summary, Evidence-Based Nursing

刘广欣, 孙霞, 刘莉, 李卫峰. 迷你中长导管留置与维护的最佳证据总结[J]. 中华护理杂志, 2024, 59(4): 408-415.

LIU Guangxin, SUN Xia, LIU Li, LI Weifeng. Evidence summary for insertion and maintenance of mini-midline[J]. Chinese Journal of Nursing, 2024, 59(4): 408-415.

图/表 6

图1 PubMed检索策略

Figure 1 PubMed retrieval strategy

图2 文献筛选流程图

Figure 2 Flow chart of literature screening

表1 纳入文献的一般特征（n=10）

Table 1 Characteristics of included studies（n=10）

表2 指南的质量评价结果(n=6)

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

表3 系统评价的质量评价结果（n=2）

Table 3 Quality evaluation of the systematic reviews（n=2）

表4 迷你中长导管留置与维护的最佳证据

Table 4 Evidence summary for insertion and maintenance of mini-midline

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