内科危重症住院患者DVT预防的证据总结  

Evidence summary for DVT prophylaxis in critically ill hospitalized patients in internal medicine department

作　　者：张煜[1] 张春艳[1] 王淑芹[1] 董亮[1] 万娜[1] 贾燕瑞[1] 高凤莉[2] Zhang Yu;Zhang Chunyan;Wang Shuqin;Dong Liang;Wan Na;Jia Yanrui;Gao Fengli(Department of Respiratory and Critical Care Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 524000,China;Nursing Department,Beijing Chaoyang Hospital,Capital Medical University,Beijing 524000,China)

机构地区：[1]首都医科大学附属北京朝阳医院呼吸与危重症医学科,100020 [2]首都医科大学附属北京朝阳医院护理部,100020

出　　处：《中华现代护理杂志》2019年第36期4698-4703,共6页Chinese Journal of Modern Nursing

摘　　要：目的总结内科危重症住院患者DVT预防的最佳证据,为医疗机构及医护人员提供参考,以降低危重症患者DVT的发生率。方法针对内科危重症患者住院期间DVT预防提出PICO问题,计算机检索PubMed、Cochran Library、BMJ Best Practice、UpToDate、Ovid、Web of Science、Joanna Briggs Institute循证卫生保健中心数据库、美国指南网、英国国家临床医学研究所、苏格兰院际指南网、国际指南协作网、安大略注册护士协会和中国生物医学文献数据库等关于内科危重症住院患者DVT预防的所有证据,包括指南、系统评价、证据总结及与证据密切相关的原始数据,并进行文献质量评价,根据JBI证据推荐级别系统(2014版)确定证据的推荐级别。结果通过电子数据库检索共纳入文献15篇,包括指南6篇、证据总结5篇、系统评价4篇。共总结出内科急危重症患者DVT预防的证据21条,包括DVT风险的评估、药物预防、机械预防、联合预防及教育管理等。结论本研究总结了目前关于内科危重症患者DVT预防的最佳证据,可为临床提供可参考的循证依据。通过最佳证据的应用,以促进内科急危重患者DVT的预防,改善患者结局,提高护理质量。Objective To summarize the best evidence for the prevention of deep venous thrombosis(DVT)in critically ill patients,and to provide a reference for medical institutions and medical staff,so as to reduce the incidence of DVT in critically ill patients.Methods The PICO problem was raised for the prevention of DVT in critically ill patients during hospitalization.All evidence concerning the prevention of deep venous thrombosis in critically ill patients were retrieved from PubMed,Cochran Library,BMJ Best Practice,UpToDate,Ovid,Web of Science,Joanna Briggs Institute Evidence-based Health Care Center Database,National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),Guidelines International Network(GIN),Registered Nurses'Association of Ontario(RNAO)and China Biology Medicine disc(CBMdisc)by computer,which included guidelines,systematic evaluation,evidence summary and original data intimately related to evidence.The literature quality was evaluated and the recommendation level of evidence was determined according to the JBI evidence recommendation level system(2014 edition).Results A total of 15 references were included through electronic database retrieval,including 6 guidelines,5 evidence summaries and 4 systematic evaluations.According to the judgment of comprehensive professionals,totally 21 evidence selected,including the risk assessment of deep venous thrombosis,drug prevention,mechanical prevention,combined prevention and educational management.Conclusions This study summarizes the best evidence for the prevention of DVT in critically ill patients,and helps nurses with ICU decision-making,through the application of best evidence,to promote the prevention of deep venous thrombosis in critical internal medicine patients,improve the outcome of patients and elevate the quality of nursing care.

关 键 词：重症监护 深静脉血栓 危重症患者 循证护理 证据总结 

分 类 号：R473.5[医药卫生—护理学]