Abstract:

Objective To evaluate and summarize the best evidence for non-pharmacological management of postoperative nausea and vomiting,and to provide evidence for clinical nurses to prevent postoperative nausea and vomiting. Methods We systematically searched for evidence on postoperative nausea and vomiting in databases such as UptoDate,Chinese Biomedical Literature Database,CNKI,Website of Chinese Medical Association Anesthesia Branch,BMJ Best Practice,the Joanna Briggs Institute,Cochrane Library,etc. The retrieved evidence included clinical decision-making,guidelines,systematic reviews,etc. The search time limit is from the establishment of the databases to December 31,2020. There were 2 researchers evaluating the quality of the literature and extracting the data. Results A total of 20 articles were included in this study,including 1 clinical decision,3 guidelines,and 16 systematic reviews. Finally,8 pieces of evidence were summarized from 4 aspects,including risk assessment,routine management,non-pharmacological interventions,and cost-benefit analysis. Conclusion Our research summed the best evidence on the risk assessment and non-pharmacological management of postoperative nausea and vomiting. In the actual clinical application,it is necessary to fully consider the clinical situation,combine the judgment of professionals and the wishes of patients,follow the principle of individualization,analyze the obstacles and facilitating factors of the application of evidence,and apply the evidence to the clinical practice prudently.

Key words: Postoperative Nausea and Vomiting, Non-Pharmacological Management, Evidence Summary, Stimulation of Acupuncture Point, Aromatherapy Treatment, Evdence-Based Nursing

摘要：

目的 评价、总结国内外术后恶心呕吐非药物管理的最佳证据,为临床护理人员预防术后恶心呕吐提供参考。方法 系统检索中国生物医学文献数据库、中国知网、中华医学会麻醉分会官网、UpToDate、BMJ Best Practice、乔安娜布里格斯研究所循证卫生保健研究中心、Cochrane Library等数据库中关于术后恶心呕吐管理的证据,包括临床决策、指南、系统评价等。检索时限为建库至2020年12月31日。由2名研究者进行文献质量评价和资料提取。+++结果该研究共纳入20篇文献,包括1篇临床决策、3篇指南、16篇系统评价。最终从风险评估、常规化管理、非药物干预措施以及成本效益分析4个方面总结了8条最佳证据。结论 该研究总结的证据可为临床医护人员开展术后恶心呕吐风险评估和非药物管理实践提供依据。在临床应用时,需要充分考虑临床情景,结合专业人士的判断及患者的意愿,遵循个体化原则,分析证据应用的障碍因素及促进因素,审慎地将证据应用于临床实践中。

关键词: 术后恶心呕吐, 非药物管理, 证据总结, 穴位疗法, 芳香疗法, 循证护理学