促进维持性血液透析患者自体动静脉内瘘成熟的最佳证据总结  

Summary of the best evidence for promoting maturation of autologous arteriovenous fistulas in patients undergoing maintenance hemodialysis

作　　者：朱文博 夏京华 周跃 宋丹 白雪 郝静 刘萍 关玉霞 Zhu Wenbo;Xia Jinghua;Zhou Yue;Song Dan;Bai Xue;Hao Jing;Liu Ping;Guan Yuxia(Blood Purification Center,Department of Nephrology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Intensive Care Unit,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;No.1 Department of Nephrology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院肾内科血液净化中心,北京100730 [2]中国医学科学院北京协和医院内科重症监护室,北京100730 [3]中国医学科学院北京协和医院肾内科一病房,北京100730

出　　处：《中华现代护理杂志》2023年第17期2251-2259,共9页Chinese Journal of Modern Nursing

摘　　要：目的对促进维持性血液透析(MHD)患者自体动静脉内瘘(AVF)成熟的最佳证据进行检索、评价及汇总。方法遵循循证护理学相关方法,按照"6S"金字塔模型对相关网站及数据库进行证据检索,包括临床决策、指南、专家共识、团体标准、系统评价。检索时限为2012年4月20日—2022年4月20日。由2名研究者对纳入研究进行质量评价,由证据小组对证据进行提取和汇总。采用澳大利亚乔安娜布里格斯研究所(JBI)证据预分级系统(2014版)对证据进行分级。结果共纳入17篇文献,包括临床决策1篇、指南6篇、专家共识1篇、团体标准1篇、系统评价8篇。从团队教育、围手术期管理、功能锻炼、物理疗法、药物应用、首次穿刺时机及方案6个方面汇总了28条最佳证据。结论促进MHD患者AVF成熟的最佳证据为医务人员规范管理MHD患者AVF提供参考。建议医务人员应用相关证据时结合医疗条件、临床判断及患者意愿制定个性化方案。Objective To search,review and summarize the best evidence on promoting maturation of autologous arteriovenous fistula(AVF)in patients undergoing maintenance hemodialysis(MHD).Methods In accordance with the relevant methods of evidence-based nursing,evidence was retrieved from relevant websites and databases according to the"6S"pyramid model,including clinical decision-making,guidelines,expert consensus,group standards,and systematic reviews.The search time limit was from April 20,2012 to April 20,2022.Two investigators assessed the quality of the evidence,and the evidence team extracted and summarized the evidence.Results A total of 17 articles were included,including 1 clinical decision-making,6 guidelines,1 expert consensus,1 group standard and 8 systematic reviews.Totally 28 best evidences were summarized from 6 aspects:team education,perioperative management,functional exercise,physical therapy,drug application,first puncture timing and scheme.Conclusions The best evidence provides a reference for medical staff to standardize the management of AVF in MHD patients.It is recommended that medical staff develop individualized plans based on medical conditions,clinical judgment,and patient wishes when applying relevant evidence.

关 键 词：动静脉瘘 维持性血液透析 证据总结 循证护理 

分 类 号：R473.5[医药卫生—护理学]