成人急性呼吸窘迫综合征俯卧位机械通气患者压力性损伤预防的最佳证据总结  

Best evidence summary for prevention of pressure injury in adult patients with acute respiratory distress syndrome and mechanical ventilation in prone position

作　　者：袁潇 杨湘英 吴清清 章炜 戴伟英 姚欢 汤桂芳 雷宇 Yuan Xiao;Yang Xiangying;Wu Qingqing;Zhang Wei;Dai Weiying;Yao Huan;Tang Guifang;Lei Yu(Department of Hepatobiliary Surgery,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Intensive Care Unit,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Hemodialysis Room,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Emergency Department,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院肝胆外科,310006 [2]浙江大学医学院附属杭州市第一人民医院ICU,310006 [3]浙江大学医学院附属杭州市第一人民医院血透室,310006 [4]浙江大学医学院附属杭州市第一人民医院急诊科,310006

出　　处：《中华现代护理杂志》2021年第30期4110-4115,共6页Chinese Journal of Modern Nursing

基　　金：浙江省卫生健康新技术产品研发项目(2021PY016);2020—2024年杭州市医学重点学科建设项目(杭卫发【2021】21号)。

摘　　要：目的检索、评价和总结成人ARDS俯卧位机械通气患者压力性损伤预防的证据,为临床护士对成人ARDS俯卧位机械通气患者压力性损伤的管理提供依据。方法系统检索UpToDate、BMJ Best Practice、国际指南协作网、美国指南网、英国国家健康学会、Joanna Briggs Institute(JBI)循证卫生保健中心、Cochrane Library、医脉通、EMBASE、PubMed、BMJ、CNKI、万方数据库、中国生物医学文献服务系统中关于成人ARDS俯卧位机械通气患者压力性损伤预防的证据,包括临床决策、指南、证据总结、系统评价、Meta分析、RCT及类试验研究。检索时限为2010年12月1日—2020年12月1日。由4名人员进行文献质量评价,由2名人员对纳入的文献进行提取和汇总。结果最终纳入7篇文献,1篇临床决策、3篇指南、2篇RCT、1篇类试验研究。从评估、干预措施、监管、护理人员专业知识培训及预防遵循原则5个方面,提取出12条证据。结论本研究总结的成人ARDS俯卧位机械通气患者压力性损伤预防的最佳证据便于临床护理人员对患者进行更具针对性、科学性的压力性损伤的评估及护理。Objective To retrieve,evaluate and summarize the evidence for the prevention of pressure injury in adult patients with acute respiratory distress syndrome(ARDS)and mechanical ventilation in prone position,to provide a basis for clinical nurses in the management of pressure injury in patients with mechanical ventilation in the prone position of ARDS.Method UpToDate,BMJ Best Practice,Guidelines International Network,National Guideline Clearinghouse,National Institute for Health and Clinical Excellence,Joanna Briggs Institute(JBI)Evidence-based Health Care Centre,Cochrane Library,Medlive,EMBASE,PubMed,BMJ,CNKI,Wanfang Database and SinoMed were systematically retrieved to search evidence on the prevention of pressure injury in adults with ARDS and mechanical ventilation in prone position, includingclinical decision-making, guidelines, evidence summary, systematic evaluation, Meta-analysis, RCT andquasi-experimental studies. The search time limit was from December 1, 2010 to December 1, 2020. Theliterature quality was evaluated by 4 personnel, and the included literature was extracted and summarized by2 personnel. Result Finally, 7 articles were included, including 1 clinical decision, 3 guidelines, 2 RCTsand 1 quasi-experimental study. A total of 12 pieces of evidence were extracted from 5 aspects, such asevaluation, intervention measures, supervision, professional knowledge training of nursing staff and principlesof prevention and compliance. Conclusions The best evidence for the prevention of pressure injury in adultARDS patients with prone mechanical ventilation summarized in this study is convenient for clinical nurses toconduct more targeted and scientific evaluation and care of pressure injury for patients.

关 键 词：呼吸窘迫综合征 成人 俯卧位 机械通气 压力性损伤 证据总结 

分 类 号：R473.5[医药卫生—护理学]