儿童中心静脉导管相关性血栓预防的最佳证据总结  

Summary of best evidence for central venous catheter-associated thrombosis prevention in children

作　　者：关汭昕 邢唯杰 张丹[1] 张葆荣[1] 赵晓霜[3] Guan Ruixin;Xing Weijie;Zhang Dan;Zhang Baorong;Zhao Xiaoshuang(Pediatric Intensive Care Unit,the First Hospital of Jilin University,Changchun 130021,China;Evidence-based Nursing Center,Fudan University,Shanghai 200032,China;Nursing Department,the First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院儿童重症医学科,长春130021 [2]复旦大学循证护理中心,上海200032 [3]吉林大学第一医院护理部,长春130021

出　　处：《中华现代护理杂志》2022年第18期2437-2442,共6页Chinese Journal of Modern Nursing

基　　金：复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202115)。

摘　　要：目的检索、评价和整合儿童中心静脉导管相关性血栓预防的最佳证据,为儿童导管相关性血栓预防临床护理方案提供依据。方法计算机检索UpToDate、BMJ Best Practice、JBI Evidence Synthesis、Cochrane Library、CINAHL、国际指南协作网、美国国立指南库、ACP Journal Club、PubMed、中国医脉通指南网、中国生物医学数据库、万方数据库、中国知网,检索时限均为2011年6月30日—2021年6月30日。由4名研究员独立筛选文献,对符合质量标准的文献进行证据提取和总结。结果共纳入10篇文献,包括指南4篇、专家共识3篇、证据总结2篇、系统评价1篇。总结出儿童中心静脉导管人员培训、风险因素评估、中心静脉导管置入、导管维护及血栓预防5个方面24条证据。结论儿童中心静脉导管相关性血栓预防的最佳证据内容全面广泛,指导性及可操作性强,可为儿童导管相关性血栓预防临床护理方案提供依据。医护人员可从以上5个方面针对不同年龄段患儿特点进一步细化循证护理实践方案,规范中心静脉导管置入及维护过程,并对患儿进行药物或非药物预防。Objective To retrieve,evaluate,and integrate the best evidence for the prevention of central venous catheter-associated thrombosis in children,so as to provide a basis for clinical nursing programs for children with catheter-associated thrombosis.Methods UpToDate,British Medical Journal Best Practice,Joanna Briggs Institute Evidence Synthesis,the Cochrane Library,CINAHL,Guideline International Network,National Guideline Clearinghouse,ACP Journal Club,PubMed,China Medlive Guidelines Network,China Biomedical Database,WanFang Data,China National Knowledge Infrastructure were retrieved by computer.The retrieval time limit was from June 30,2011 to June 30,2021.Four researchers independently screened the article,and extracted and summarized the article that met the quality standards.Results A total of 10 articles were included,including four guidelines,three expert consensus articles,two evidence summaries,and one systematic review.A total of 24 pieces of evidence were summarized in five aspects of children's central venous catheter training,risk factor assessment,central venous catheter placement,catheter maintenance and thrombosis prevention.Conclusions The best evidence for the prevention of central venous catheter-associated thrombosis in children is comprehensive and extensive,instructive and actionable,and can provide a basis for the clinical nursing program of catheter-associated thrombosis prevention in children.Medical and nursing staff can further refine evidence-based nursing practice programs according to the characteristics of children of different ages from the above five aspects,standardize the process of central venous catheter placement and maintenance,and provide children with drug or non-drug prevention.

关 键 词：儿童 中心静脉导管 血栓 证据总结 循证护理 

分 类 号：R473.72[医药卫生—护理学]