儿童PICC导管相关血栓预防的最佳证据总结  

Summary of the best evidence for peripherally inserted central catheter-related thrombosis in children

作　　者：张彩云[1] 王春立[1] 吴思婷 丁亚光[1] 沈南平[2] 何梦雪[2] Zhang Caiyun;Wang Chunli;Wu Siting;Ding Yaguang;Shen Nanping;He Mengxue(Department of Nursing,Beijing Children's Hospital,Capital Medical University(National Center for Children's Health,China),Beijing 100045,China;Department of Nursing,Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine(National Center for Children's Health,China),Shanghai 200127,China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院护理部,北京100045 [2]国家儿童医学中心上海交通大学医学院附属上海儿童医学中心护理部,上海200127

出　　处：《中华现代护理杂志》2022年第12期1552-1557,共6页Chinese Journal of Modern Nursing

基　　金：首都医科大学附属北京儿童医院护理专项基金(YHL201901);中华医学会杂志社2021—2022年护理学科研究课题(CMAPH-NRI2021044);中国妇幼保健协会妇女儿健康临床标准与规范化项目(ZGFY-B-201903)。

摘　　要：目的检索、评价和总结儿童经外周置入中心静脉置管(PICC)导管相关血栓预防的最佳证据。方法应用循证护理的方法,计算机检索国内外指南网、相关学会网站及数据库中与儿童患者PICC置管前后及使用过程中预防血栓相关的指南、证据总结、专家共识、系统评价。检索时间为建库至2021年6月30日。由2名研究人员采用临床指南研究与评价系统Ⅱ和澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心对应的评价标准(2016)对文献质量进行独立评价,通过专家论证,对符合标准的文献进行资料提取并依据JBI证据预分级系统(2014版)进行证据分级与推荐级别分级。结果共纳入11篇文献,其中包括4篇指南、1篇系统评价、1篇专家共识、5篇证据总结。从组织管理、导管的选择、血管的选择与穿刺、导管尖端位置、物理预防、药物预防、评估7个方面汇总了27条证据。结论本研究汇总并分析了儿童PICC导管相关血栓预防的最佳证据,为临床规范运用和实践儿童PICC导管相关血栓的预防提供了循证证据支持和参考意见。Objective To retrieve,evaluate,and summarize the best evidence for peripherally inserted central catheter(PICC)related thrombosis in children.Methods Guideline websites,relevant society websites,and databases at China and abroad were searched for guidelines,evidence summaries,expert consensuses,and systematic reviews related to thrombosis before and after PICC catheterization in children published up to June 30,2021 based on evidence-based nursing.The quality of the literature was independently evaluated by 2 researchers with reference to Appraisal of Guidelines for Research and Evaluation InstrumentⅡand the criteria of the Joanna Briggs Institute(JBI)in Australia(2016).Data were extracted from the literatures that met the standards through expert demonstration,and the evidence was graded and recommended according to the JBI evidence pre-grading system(2014 edition).Results A total of 11 articles were included,including 4 guidelines,1 systematic review,1 expert consensus,and 5 evidence summaries.27 pieces of evidence were summarized from 7 aspects:organizational management,catheter selection,blood vessel selection and puncture,location of catheter tip,physical prevention,drug prevention,and evaluation.Conclusions This paper summarizes and analyzes the best evidence for PICC-related thrombosis in children and provides an evidence-based reference for the clinical application and practice of PICC-related thrombosis in children.

关 键 词：儿童 PICC 导管相关血栓 预防 证据总结 

分 类 号：R473.72[医药卫生—护理学]