植入心室辅助装置患者经皮线缆伤口感染预防与处理最佳证据总结  

Summary of the best evidence for the prevention and management of wound infections in patients with ventricular assist devices

作　　者：郭红艳[1] 李晶[1] 王玉英[2] 丁炎明[1] 陈飞 Guo Hongyan;Li Jing;Wang Yuying;Ding Yanming;Chen Fei(Nursing Department,Peking University First Hospital,Beijing 100034,China;Department of Thoracic Surgery,Peking University First Hospital,Beijing 100034,China;Department of Gynecology and Obstetrics,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院护理部,北京100034 [2]北京大学第一医院胸外科,北京100034 [3]北京大学第一医院妇产科,北京100034

出　　处：《中华现代护理杂志》2021年第35期4781-4787,共7页Chinese Journal of Modern Nursing

摘　　要：目的总结植入心室辅助装置患者经皮线缆伤口感染预防与处理的最佳证据,为临床实践提供参考。方法按照“6S”证据模型,系统检索国际指南网、美国指南网、苏格兰大学校际指南网、英国卫生与临床优化研究所、加拿大医学会临床实践指南文库、澳大利亚国家卫生和医学研究委员会网站和医脉通等指南网及PubMed、BMJ Best Practice、Joanna Briggs Institute(JBI)循证卫生保健中心数据库、UpToDate、CINAHL、Embase、Cochrane Library等数据库中关于植入心室辅助装置患者经皮线缆伤口感染预防和处理的证据,包括临床决策、指南、证据总结和专家共识。检索时限为建库至2021年5月31日。由2名研究人员对文献质量进行独立评价,并对符合质量标准的文献进行证据提取和汇总。结果共纳入文献11篇,包括指南4篇、系统评价3篇和专家共识4篇;从经皮线缆固定、伤口换药、伤口感染监测与评估、伤口感染处理、患者及其照护者健康教育5个方面汇总了24条证据。结论本研究总结了植入心室辅助装置患者经皮线缆伤口感染预防与处理的最佳证据,医务人员可根据患者意愿和临床具体情况,结合专业判断,形成有效、可行的护理策略,从而提高护理质量。Objective To summarize the best evidence for the prevention and management of wound infections in patients with ventricular assist devices,so as to provide a reference for clinical practice.Methods According to the“6S”evidence model,we systematically searched the evidence for prevention and management of wound infections in patients with ventricular assist devices in the Guidelines International Network,National Guideline Clearinghouse,Scottish Intercollegiate Guidelines Network,National Institute for Health and Clinical Excellence,Clinical Practice Guideline of Canadian Medical Association,Australian Government National Health and Medical Research Council,Medlive and other guideline network,and PubMed,British Medical Journal(BMJ)Best Practice,Joanna Briggs Institute(JBI)Evidence-based Health Care Center Database,UpToDate,CINAHL,Embase and Cochrane Library.Evidence included clinical decisionmaking,guidelines,evidence summary and expert consensus.The search time limit was from the establishment of the database to May 31,2021.Two researchers independently evaluated the quality of the article,and extracted and summarized the evidence that met the quality standards.Results A total of 11 articles were included,including 4 guidelines,3 systematic reviews and 4 expert consensus.A total of 24 pieces of evidence were collected from 5 aspects,namely,percutaneous cable fixation,wound dressing,wound infection monitoring and evaluation,wound infection management,and health education for patients and their caregivers.Conclusions This study summarizes the best evidence for the prevention and management of percutaneous cable wound infections in patients with ventricular assist devices.Medical and nursing staff can form effective and feasible nursing strategies according to the patient's wishes and specific clinical conditions,combined with professional judgment,to improve the quality of nursing care.

关 键 词：循证护理 伤口 感染预防 心室辅助装置 经皮线缆 

分 类 号：R473.6[医药卫生—护理学]