摘要
目的总结神经外科ICU患者误吸防治与管理的最佳证据,为临床护理工作提供依据。方法系统检索国内外指南网、相关机构网站及数据库等关于神经外科ICU患者误吸防治与管理的相关证据,包括指南、共识系统评价及RCT等,检索时限为2010年1月1日—2019年6月30日,语种不限。由2名研究者对纳入的文献质量进行评价,并对符合质量标准的文献进行证据提取。结果共纳入9篇临床实践指南、8篇专家共识、13篇Meta分析/系统评价和10篇RCT研究,对其进行汇总提取,形成包括10个一级指标29个二级指标的最终版误吸防治与管理最佳证据。结论医护人员应在误吸风险早期评估,人工气道管理、体位管理、肠内营养管理、镇静镇痛管理等方面采取有效措施,通过应用最佳证据,降低神经外科ICU患者误吸发生率。此外,医院应对医护人员进行形式多样的教育培训,形成跨专科合作团队,加强对误吸的预防与管理工作。
Objective To summarize the best evidence for prevention and management of aspiration in neurosurgical ICU patients and provide evidence for clinical nursing work.Methods Relevant evidence on prevention and management of aspiration in neurosurgical ICU patients,including guidelines,consensus,system reviews,and randomized controlled trials(RCTs)which were published from 1st January,2010 to 30th June,2019 in any language was retrieved from guideline websites,relevant websites and databases.Two researchers evaluated the quality of the included literature and performed evidence extraction on those literatures that met the quality standards.Results Totally 9 clinical practice guidelines,8 expert consensus,13 Meta analysis/systematic reviews and 10 RCTs were included,which were collected and extracted to form the final version of best evidence for aspiration prevention and management including 10 primary indicators and 29 secondary indicators.Conclusions Medical staff should take effective measures in early assessment of aspiration risks,artificial airway management,position management,enteral nutrition management,sedation and analgesia management,etc.,and reduce the incidence of aspiration in neurosurgical ICU patients by applying the best evidence.In addition,hospitals should provide various forms of education and training to medical staff,form transdisciplinary cooperation teams,and strengthen the prevention and management of aspiration.
作者
张博寒
田莉
焦帅
刘悦
蔡卫新
肖倩
Zhang Bohan;Tian Li;Jiao Shuai;Liu Yue;Cai Weixin;Xiao Qian(School of Nursing,Capital Medical University,Beijing 100069,China;Yanjing Medical College,Capital Medical University,Beijing 101300,China;Department of Nursing,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中华现代护理杂志》
2020年第6期741-748,共8页
Chinese Journal of Modern Nursing
基金
首都医科大学科研培育基金课题(PYZ2018026)。
关键词
神经外科
重症医学
循证护理
误吸
防治
管理
Neurosurgery
Critical medicine
Evidence-based nursing
Aspiration
Prevention
Management
