成人气管插管非计划性拔管危险因素的证据总结  

Evidence summary on risk factors of unplanned extubation of endotracheal intubation in adults

作　　者：鲁志卉 王颖[1] 王萧萧 王蕾[1] LU Zhihui;WANG Ying;WANG Xiaoxiao;WANG Lei(Tongji Hospital,Tongji Medical College of HUST,Hubei 430030 China)

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北430030

出　　处：《循证护理》2022年第4期448-454,共7页Chinese Evidence-Based Nursing

基　　金：华中科技大学自主创新研究基金资助项目,编号:2015TS084。

摘　　要：目的:检索、评价总结成人气管插管非计划性拔管危险因素的最佳证据,为临床预防措施的制定提供循证依据。方法:系统检索国际指南协作网、英国国家临床优化研究所指南库、苏格兰学院间指南网、美国国家临床诊疗指南数据库、医脉通、加拿大安大略注册护士协会、美国急危重症护理学会、BMJ最佳临床实践、澳大利亚JBI循证卫生保健中心(JBI)数据库、UpToDate、the Cochrane Library、Web of Science、PubMed、MedLine、OVID、CINAHL、EMbase、中国知网、万方数据库和维普数据库中所有关成人气管插管非计划性拔管危险因素的证据,包括指南、专家共识、最佳实践、系统评价及证据总结,检索时限为建库至2020年8月。由2名研究者独立完成对文献的质量评价,对符合质量标准的文献进行证据提取及总结。结果:共纳入14篇文献,其中2篇指南,2篇证据总结,1篇推荐实践,2篇专家共识,7篇系统评价,最终总结了病人方面、管理方面、治疗因素、导管因素和环境因素5方面共21条证据。结论:本研究总结了目前成人气管插管非计划性拔管危险因素的最佳证据,为护理人员构建风险评估量表及制定相应护理措施提供循证依据,对科学防范气管插管非计划性拔管具有指导意义。Objective:To search,evaluate and summarize the best evidences on the risk factors of unplanned extubation of endotracheal intubation in adults,so as to provide evidence-based basis for the formulation of clinical preventive measures.Methods:All evidences on risk factors of unplanned extubation of endotracheal intubation in adults,including guidelines,expert consensus,best practices,systematic evaluation and evidence summary were searched from GIN,NICE,SIGN,NGC,Yimaitong Network,RNAO,AACN,BMJ Best Clinical Practice,Australia JBI Evidence-Based Health Care Center(JBI),UpToDate,the Cochrane Library,Web of Science PubMed,MedLine,OVID,CINAHL,EMbase,CNKI,WanFang Date and VIP.The retrieval time was from inception to August 2020.Two researchers independently completed the quality evaluation of the literature,and extracted and summarized the evidences that met the quality standards.Results:A total of 14 articles were included,involving 2 guidelines,2 evidence summaries,1 recommended practice,2 expert consensus,and 7 systematic reviews.Finally,21 evidences were summarized in 5 aspects:patient,management,treatment factors catheter factors and environmental factors.Conclusion:This study summarizes the best evidences on the risk factors of unplanned extubation of endotracheal intubation in adults,provides evidence-based basis for nurses to construct risk assessment scale and formulate corresponding nursing measures,and has guiding significance for scientific prevention of unplanned extubation of endotracheal intubation.

关 键 词：气管插管 非计划性拔管 危险因素 证据总结 循证护理 

分 类 号：R472[医药卫生—护理学]