气管插管非计划性拔管发生现状和发生时段的系统评价  

A systematic evaluation on the occurrence status and time of the unplanned endotracheal extubation

作　　者：葛向煜[1] 朱晓玲[2] 胡雁[1] 徐建鸣[2] 秦薇[2] 潘文彦[2] 

机构地区：[1]复旦大学护理学院 [2]复旦大学附属中山医院

出　　处：《护理研究（上旬版）》2014年第4期1274-1277,共4页Chinese Nursing Researsh

基　　金：美国中华医学基金会(CMB)护理青年教师科研基金资助项目,编号:10-020-201105;2010年复旦大学护理科研基金重点项目,编号:FNSF201110

摘　　要：[目的]系统评价国内外气管插管非计划性拔管（UEX）的发生现状和发生时段.[方法]计算机检索Pubmed,OVID,Webof Knowledge,CINAHL,中国生物医学期刊网（CBMdisc）、中国期刊全文数据库（CNKI）、万方数据库.纳入中英文发表的关于成人UEX 发生率的研究,采用澳大利亚循证卫生保健中心（Joanna Briggs Institute,JBI）制定的文献质量评价标准评价研究质量,描述UEX 发生率、再插管率及发生的高危时间段.[结果]共纳入22项病例对照/队列研究,1项描述性研究,合计32237 例气管插管病人,1912 例UEX 事件.UEX 事件发生率为8.7% （IQR6.50%～10.95%）,高危时间段包括夜班、撤机阶段及交接班前后1h.[结论]UEX事件中自行拔管更为多见,但是意外拔管再插管率较高,尚需加强高危时间段的监护以预防UEX.Objective:To systematiclaly evaluate the status quo of occurrence and occurrence time of the unplanned endotracheal extubation(UEX)in abroad and at home systematically.Methods:Computer search was conducted in Pubmed,OVID,Web of Knowledge,CINAHL,CBMdisc,CNKI and WanFang Database.The studies on the incidence of UEX published in English,and the publication language was limited to English and Chinese.The quality assessment of publication was based on JBI criteria,and the descriptive analysis was performed to analyze the incidence and reintubation of unplanned endotracheal extubation.Results:A total of 22 case-control/cohort studies and 1descriptive study were included,involving 32 237 endotracheal intubated patients and 1 912 UEX cases.The incidence rate of UEX was 8.7%(IQR 6.50%~10.95%).The high risk periods of UEX included night shift,weaning process and during the change of shifts before and after 1h.Conclusion:Self-extubation in UEX event was more common. However,the reintubation rate in accidental extubation was higher. The monitoring of high-risk time period still need to be strengthened to prevent UEX.

关 键 词：气管插管 非计划性拔管 系统评价 护理 

分 类 号：R472[医药卫生—护理学]