Abstract:

Objective To construct an intra-hospital emergency nursing program for patients with acute aortic dissection suitable for the clinical scenarios in China，aiming to provide theoretical and practical guidance for carrying out evidence-based nursing practice. Methods Based on evidence-based methods，domestic and foreign literature was retrieved and summarized for the best evidence to form the first draft of intra-hospital emergency nursing program for acute aortic dissection. Delphi technique was used to conduct 2 rounds of correspondence among 30 selected emergency medical and nursing experts，and the final program was improved and established. Results 58 pieces of literature were included，and 95 pieces of best evidence were summarized. The first draft of the program was formed and 2 rounds of correspondence were conducted，with the recovery rate of the questionnaire of 100%，the expert authority coefficients of 0.869 and 0.868，the coefficient of variation of 0~0.17；the coordination coefficients of 0.473 and 0.613，respectively（P<0.05）. The final intra-hospital emergency nursing programe for acute aortic dissection includes 3 level Ⅰ indicators，17 level Ⅱ indicators and 97 level Ⅲ indicators，including pre-examination triage，emergency rescue and nursing，and safe transferring. Conclusion The constructed intra-hospital emergency nursing programe for acute aortic dissection has detailed contents，wide coverage，strong scientificity and operability，which can provide references for emergency nursing practice.

Key words: Aortic Dissection, First Aid, Evidence-Based Nursing, Delphi Technique

摘要：

目的 构建适宜中国临床情境的急性主动脉夹层患者院内急救护理方案，为开展循证护理实践提供理论和实践指导。 方法 基于循证方法检索国内外相关文献并对其进行质量评价，总结最佳证据，形成急性主动脉夹层患者院内急救护理方案初稿。运用德尔菲技术对30名急诊医疗、护理专家进行2轮函询，完善并确立最终方案。 结果 共纳入58篇文献，总结了95条最佳证据，形成方案初稿，2轮函询问卷回收率均为100%，专家权威系数分别为0.869、0.868，变异系数均为0~0.17，肯德尔和谐系数分别为0.473、0.613（P<0.05）。最终构建的急性主动脉夹层患者院内急救护理方案包括3个一级指标（预检分诊、急诊抢救与护理、安全转运）、17个二级指标和97个三级指标。 结论 该研究构建的急性主动脉夹层院内急救护理方案内容详实、涵盖面广、科学性强、可操作性强，可为急诊护理实践提供指导。

关键词: 主动脉夹层, 急救, 循证护理学, 德尔菲技术