急性主动脉夹层急诊目标血压管理的最佳证据总结  

Summary of best evidence for emergency target blood pressure management of acute aortic dissection

作　　者：徐伟[1] 陈晓莉[2] 牛聪影 林文风 程宝珍 孙立琴 Xu Wei;Chen Xiaoli;Niu Congying;Lin Wenfeng;Cheng Baozhen;Sun Liqin(Department of Emergency,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230000,China;School of Nursing,Wuhan University,Wuhan 430071,China;School of Nursing,Anhui University of Chinese Medicine,Hefei 230000,China)

机构地区：[1]中国科学技术大学附属第一医院急诊医学科,合肥230000 [2]武汉大学护理学院,武汉430071 [3]安徽中医药大学护理学院,合肥230000

出　　处：《中国实用护理杂志》2022年第34期2703-2710,共8页Chinese Journal of Practical Nursing

摘　　要：目的评鉴与总结急性主动脉夹层急诊目标血压管理的最佳证据,为开展急诊目标血压管理的循证实践提供指导。方法按照"6S"证据金字塔模型,检索2010年1月1日至2021年7月1日国内外各类数据库、专业协会网站中有关急性主动脉夹层急诊目标血压管理的证据,包括临床决策、指南、专家共识、系统评价、随机对照试验、队列研究、案例系列。由2名研究者采取相应的文献质量评价工具对纳入的文献进行评价,并对B级以上的文献进行证据提取、总结。结果共纳入22篇文献,包括临床决策6篇,指南5篇,专家共识7篇,系统评价1篇,随机对照试验1篇,队列研究1篇,案例系列1篇,形成37条最佳证据,包括目标值设定、管理策略、病情观察、病史采集、监测手段、血管活性药物、非血管活性药物、辅助检查、健康教育9个主题。结论总结的最佳证据为急诊医护人员对急性主动脉夹层急诊目标血压管理提供了参考,建议急诊医护人员遵循总结的最佳证据为患者制定个体化的目标血压管理方案。Objective To evaluate and summary the relevant evidence of emergency target blood pressure management in acute aortic dissection,so as to provide guidance for the evidence-based practice of emergency target blood pressure management.Methods According to the"6S"evidence pyramid model,the evidence about emergency target blood pressure management of acute aortic dissection in various databases and professional association websites at home and abroad was retrieved,including clinical decision,guidelines,expert consensus,systematic evaluation,randomized controlled trial,cohort study,case series,etc.Two researchers used corresponding literature quality evaluation tools to evaluate the quality of the included literature,extracted and summarized the evidence of the literature above grade B.Results A total of 22 articles were included in this study,including 6 clinical decisions,5 guidelines,7 expert consensus,1 systematic evaluation,1 randomized controlled trial,1 cohort study and 1 case series,forming 37 best evidences,including 9 topics such as target value setting,management strategies,disease observation,medical history collection,monitoring methods,vasoactive drugs,non vasoactive drugs,auxiliary examination,health education.Conclusions The summarized best evidence provides a reference for emergency medical staff to manage the emergency target blood pressure of acute aortic dissection.It is recommended that emergency medical staff follow the summarized best evidence to formulate an individualized target blood pressure management scheme for patients.

关 键 词：急诊处理 急性主动脉夹层 目标血压 证据总结 循证护理 

分 类 号：R473.5[医药卫生—护理学]