脊髓损伤自主神经反射异常预防与管理证据总结  

Evidence summary of prevention and management of autonomic dysreflexia in spinal cord injury

作　　者：夏丽霞 顾则娟 王荣 纪婕 沙彬秀 XIA Lixia;GU Zejuan;WANG Rong;JI Jie;SHA Binxiu(Jiangsu Province Hospital,The First Affiliated Hospital with Nanjing Medical University,Jiangsu 210029 China)

机构地区：[1]江苏省人民医院南京医科大学第一附属医院,江苏210029

出　　处：《护理研究》2021年第5期771-781,共11页Chinese Nursing Research

基　　金：江苏省医学创新团队项目,编号:CXTDA2017019。

摘　　要：目的:总结脊髓损伤病人自主神经反射异常预防及管理的最佳证据。方法:系统检索PubMed、CINAHL、英国国家医疗保健优化研究所(NICE Clinical Guidelines)、美国国家指南网(National Guideline Clearinghouse,NGC)、加拿大安大略(RNAO)指南网、苏格兰院际指南网(SIGN)、JBI循证中心数据库、Cochrane Library、中国知网、万方数据库、中国生物医学数据库、相关网站有关脊髓损伤病人自主神经反射异常预防及管理指南、推荐实践、行业标准、证据总结、专家共识及系统评价,检索时间为建库至2020年3月31日。结果:共纳入27篇文献,其中指南17篇、专家共识1篇、证据总结7篇、系统评价2篇。总结了自主神经反射异常风险评估、针对危险因素预防、自主神经反射异常早期识别、自主神经反射异常急性发作处理、健康教育5个方面、54条最佳证据。结论:整合了脊髓损伤自主神经反射异常预防及管理的最佳证据,建议在实际应用时结合实际及病人情况,以促进最佳证据的转化应用。Objective:To summary best evidences on prevention and management of autonomic dysreflexia in spinal injury patients.Methods:Best practice,reference,evidence summary,expert consensus and systematic review regarding prevention and management of autonomic dysreflexia in spinal injury patients were searched in PubMed,CINAHL,NICE Clinical Guidelines,NGC,RNAO,SIGN,JBI,Cochrane Library,CNKI,Wanfang database and CBM from database inception to March 31,2020.Results:A total of 27 literatures were obtained,including 17 guidelines,one expert consensus,seven evidence summaries and two systematic reviews.Five aspects and fifty⁃four best evidences were developed,concerning risk assessment of autonomic dysreflexia,prevention of risk factors,early identification of autonomic dysreflexia,management of acute attack of autonomic dysreflexia,health education.Conclusion:The best evidences for the prevention and management of autonomic dysreflexia in spinal cord injury were integrated.However,It was suggested that practical application should be combined with the actual and patient conditions to promote the conversion of the best evidences.

关 键 词：脊髓损伤 自主神经反射异常 预防 管理 循证护理 最佳证据 

分 类 号：R651.2[医药卫生—外科学]