冠状动脉介入术后病人口服水化方法预防造影剂肾病的最佳证据总结  

Best evidences summary on oral hydration therapy for the prevention of contrast-induced nephropathy in patients after percutaneous coronary intervention

作　　者：钱红继 周雪梅[1] 王伶俐 吴娟[1] 缪爱凤[1] 瞿倩 张跃娟[1] 王丽华[1] QIAN Hongji;ZHOU Xuemei;WANG Lingli;WU Juan;MIAO Aifeng;QU Qian;ZHANG Yuejuan;WANG Lihua(Affiliated Hospital of Nantong University,Jiangsu 226001 China)

机构地区：[1]南通大学附属医院,江苏226001

出　　处：《护理研究》2020年第12期2062-2067,共6页Chinese Nursing Research

基　　金：2019年南通市市级科技计划(指导性)项目,编号:JCZ19086;2019年复旦大学循证护理中心南通大学附属医院证据应用基地项目。

摘　　要：[目的]检索并总结冠状动脉介入术后病人采用口服水化方法预防造影剂肾病的最佳证据,为临床提供参考依据。[方法]检索PubMed、Web of Science、OVID、Cochrane Library、循证卫生保健中心数据库(Joanna Briggs Institute,JBI)、国际指南协作网、英国国家临床优化研究所、美国国立指南库、加拿大安大略注册护士协会、苏格兰学院间指南网络、改善全球肾脏病预后组织和中国生物医学文献数据库关于冠状动脉介入术后病人采用口服水化方法预防造影剂肾病的所有证据,包括指南、专家共识、证据总结、系统评价及与证据密切相关的原始研究。由4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]共纳入文献15篇,其中指南3篇,系统评价4篇,随机对照试验4篇,类实验研究3篇,专家共识1篇。最终形成12条最佳证据。[结论]本研究总结的关于冠状动脉介入术后病人采用口服水化方法预防造影剂肾病的最佳证据,可为临床提供循证依据。建议临床应用证据时需要评估本医疗机构的临床环境、医护人员应用证据的促进因素及阻碍因素、病人的意愿及病情进行针对性的证据选择。Objective:To retrieve and summarize the best evidences of oral hydration therapy for the prevention of contrast⁃induced nephropathy in patients after percutaneous coronary intervention(PCI),so as to provide reference for clinical practice.Methods:To search the PubMed,Web of Science、Ovid、Cochrane Library、JBI Evidence-Based Health Care Center Library,Guidelines International Network(GIN),National Institute for Health and Clinical Excellence(NICE),National Guideline Clearinghouse(NGC),Registered Nurses'Association of Ontario(RNAO),the Scottish Intercollegiate Guidelines Network(SIGN),Kidney Disease:Improving Global Outcomes(KDIGO),and China Biology Medicine disc(CBMdisc).All evidence on oral hydration therapy for the prevention of contrast⁃induced nephropathy in patients after percutaneous coronary intervention,including guidelines,expert consensus,evidence summaries,systematic evaluations,and original researches closely related to evidence,were collected.The qualities of included literatures were evaluated by 4 researchers.Then,evidences were extracted from the literatures that met the quality standards.Results:A total of 15 literatures were included in this study,including 3 guidelines,4 systematic evaluations,4 randomized controlled trials,3 quasi-experiment studies and 1 expert consensus.Finally,12 pieces of best evidences were defined.Conclusions:The formed best evidences on oral hydration therapy for the prevention of contrast⁃induced nephropathy in patients after percutaneous coronary intervention in this study,which could provide evidence-based reference for clinical practice.It was suggested that we should evaluate clinical environments of the medical institutions,factors that promote and hinder the medical personnel to apply evidences,and the patient's willingness and state of illness when using evidence in clinics.Further,to make a targeted evidence selection.

关 键 词：冠状动脉介入术 造影剂肾病 口服水化 循证护理 最佳证据 

分 类 号：R47[医药卫生—护理学]