PICC相关性血栓风险评估的最佳证据总结  

Evidence summary for risk assessment of PICC-related venous thrombosis

作　　者：朱丽群[1] 庄若[2] 曹松梅[2] 周筱琴[2] 张炜[3] 周英凤[4] 李全磊[5] 

机构地区：[1]江苏大学附属医院老年科,镇江市212001 [2]江苏大学附属医院护理部,镇江市212001 [3]江苏大学附属医院消化科,镇江市212001 [4]复旦大学护理学院 [5]约翰霍普金斯大学护理学院

出　　处：《中华护理杂志》2017年第10期1179-1185,共7页Chinese Journal of Nursing

基　　金：镇江市卫生科技重点专项项目(SHW2015017);镇江市社会发展科技支撑项目(SH2013038);江苏大学临床医学专项基金(JDLCZX035)

摘　　要：目的检索、评价和总结PICC相关性血栓风险评估的最佳证据,为构建相关评估工具提供参考。方法计算机检索BMJ最佳临床实践(British Medical Journal Best Practice)、Cochrane图书馆、JBI循证卫生保健国际合作中心图书馆、加拿大安大略注册护士协会、美国指南网、国际实践指南注册平台(中文)、中国临床指南文库,以及Pub Med、EMbase、中国知网、中国生物医学数据库建库至2017年3月涉及PICC相关性血栓风险评估的所有文献,包括临床实践指南、最佳实践信息册、推荐实践及系统评价。结果共纳入8篇文献,包括临床实践指南5篇、系统评价3篇。总结个体因素、医源性因素、导管相关因素3大类别,共18项最佳证据。结论 PICC置管前进行个体化的血栓风险评估对预防PICC相关性血栓至关重要。医疗机构应按照循证证据建立PICC相关性血栓的评估制度、程序和实践标准。Objective To retrieve,appraise and summarize the best evidence of risk assessment for PICC-related venous thrombosis and provide references for establishing relevant assessment tools. Methods British Medical Journal Best Practicc,Cochrane Library,JBI Library,Registered Nurses＇ Association of Ontario （RNAO）,National Guideline Clearinghouse （NGC）,International Practice Guideline Registry Platform,China Guideline Clearinghouse （CGC）,PubMed,EMbase,CNKI and CBM were searched from inception to March , 2017 , to collect literatures includ- ing clinical practice guideline,best practice information sheet,recommended practice and systematic review regarding risk assessment for PlCC-related venous thrombosis. Results Eight studies were recruited,including five clinical practice guidelines,and three systematic reviews. Three categories （individual factors,iatrogenic factors,and catheter- related factors）and totally 18 items of best evidence were summarized. Conclusion It is critical to perform individualized risk assessment for preventing PICC-rclated venous thrombosis before PICC placement. Medical institu- tions should establish principles,procedures and practice guidelines for PICC-related venous thrombosis assessment based on best evidence.

关 键 词：导管插入术 外周 血栓栓塞 危险因素 风险评估 

分 类 号：R472[医药卫生—护理学]