骨科全身麻醉术后病人氧气驱动雾化吸入循证规范的制订与应用  

Formulation and application of evidence-based guidelines for oxygen-driven nebulization after orthopedic general anesthesia

作　　者：陶莹 仝笛 刘晶晶[1] 曾雪梅[1] 肖扬 陈正香[1] TAO Ying;TONGDi;LIUJingjing;ZENGXuemei;XIAOYang;CHENZhengxiang(Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Jiangsu 210008 China)

机构地区：[1]南京大学医学院附属鼓楼医院,江苏210008

出　　处：《护理研究》2021年第12期2128-2134,共7页Chinese Nursing Research

摘　　要：目的:应用循证的方法制订骨科全身麻醉术后病人氧气驱动雾化吸入循证规范,并应用于临床实践中检验其应用效果。方法:检索PubMed、Wiley Online Library、The Cochrane Library、Springer Link、Elsevier Science Direct(SDOS)、中国期刊全文数据库(CJFD)、维普信息资源系统、万方数据库中与氧气驱动雾化吸入主题相关的文献,总结最佳证据,并结合临床情景和专业判断,制订基于证据的质量审查标准,并在我院骨科病房开展质量审查。结果:共纳入3篇专家共识、3篇综述和1篇系统评价,总结出9条最佳证据。经临床实践后,护士对基于循证的氧气驱动雾化吸入9条指标的达标率均为100%;证据应用后,病人的咽喉部疼痛、声音嘶哑、咳嗽、咳痰症状以及病人舒适度得到改善(P<0.05)。结论:与传统雾化方案相比,基于循证的氧气驱动雾化吸入方案可提高骨科全身麻醉术后病人的雾化效果,减少咽喉部疼痛、声音嘶哑等相关并发症的发生,增加病人舒适度。Objective:To formulate evidence-based guidelines for oxygen-driven nebulization after orthopedic general anesthesia and to test their application effects in clinical practice.Methods:The articles related to the topic of oxygen-driven nebulization inhalation were searched in PubMed,Wiley Online Library,The Cochrane Library,Springer Link,ELSEVIER Science Direct(SDOS),China Journal Full-text Database(CJFD),VIP,and Wanfang Data.And the best evidence was summarized.Then,combined with the clinical situation and professional judgment,the evidence-based quality review standard was formulated.Finally,the quality review was carried out in the orthopedic ward in our hospital.Results:Three expert consensus,three reviews and one systematic review were included,and nine best evidences,were summarized.After clinical practice,the nurses’compliance rate of nine indicators based on evidence-based oxygen-driven nebulization inhalation all reached 100%.After the application of the evidence,the patients’throat pain,hoarseness,cough,sputum expectoration,and patient comfort were all improved(P<0.05).Conclusion:Compared with the traditional nebulization scheme,the evidence-based oxygen-driven nebulization scheme could improve the nebulization effect of patients after orthopedic general anesthesia,reduce the occurrence of throat pain,hoarseness and other related complications,and enhance patients’comfort.

关 键 词：骨科 全身麻醉 手术 雾化吸入 气道管理 循证护理 

分 类 号：R473.6[医药卫生—护理学]