NICU神经调节辅助通气新生儿体位管理的证据总结  

Evidence summary of NICU neuromodulation assisted ventilation neonatal position management

作　　者：徐惠芳[1] 周敏丽 钟力力 蒋文星[1] 邓秋燕 李琳[1] 胡娜 孙锦霞 丁悦 XU Huifang;ZHOU Minli;ZHONG Lili;HAN Wenxing;DENG Qiuyan;LI Lin;HU Na;SUN Jinxia;DING Yue(Jiangxi Children's Hospital,Nanchang,330006,China)

机构地区：[1]江西省儿童医院,江西省南昌市330006

出　　处：《护理实践与研究》2023年第13期1953-1960,共8页Nursing Practice and Research

摘　　要：目的系统检索并筛选NICU神经调节辅助通气新生儿体位管理的系列证据,并对最佳证据进行总结。方法检索PubMed、Web of Science、Elsevier、Cochrane Library、中国知网、万方、维普等数据库关于NICU神经调节辅助通气新生儿体位管理的相关证据,包括指南、专家共识、护理方案、病例对照研究、Meta分析、随机对照试验(RCT)等,检索时限为2000年1月—2022年8月。由2名拥有循证护理背景研究者对纳入的文献进行质量独立评价并互相核对,出现争议时由第3方进行裁决,对符合纳入排除标准的文献进行证据提取。结果共纳入18篇文献,其中指南4篇,专家共识1篇,护理方案2篇,系统评价2篇,Meta分析3篇,病例对照研究1篇,RCT 5篇,从体位和风险评估、新生儿复苏时的体位摆放及其操作要点、新生儿NAVA过程中的体位转换及其操作要点、特殊疾病或情境下的体位管理、体位辅助工具的使用及皮肤保护5个方面对NICU神经调节辅助通气新生儿体位管理进行证据汇总,共形成最佳证据。结论该研究总结了NICU神经调节辅助通气的新生儿体位管理的最佳证据,为规范NICU神经调节辅助通气的新生儿体位管理提供了循证依据,建议护理人员在应用证据时综合考虑临床实际情况选择性应用最佳证据,提高新生儿存活率。Objective To systematically search and screen a series of evidences for neonatal position management with neuromodulation assisted ventilation in NICU,and to summarize the best evidence.Methods PubMed,Web of Science,Elsevier,Cochrane Library,CNKI,Wanfang,VIP and other databases were searched for relevant evidence on neonatal position management with neuromodulation assisted ventilation in NICU,including guidelines,expert consensus,nursing plan,case-control study,Meta analysis,randomized controlled trial(RCT),etc.The retrieval time was from January 2000 to August 2022.Two researchers with evidencebased nursing background independently evaluated the quality of the included literature and checked each other.When there was a dispute,the third party ruled and extracted evidence from the literature that met the inclusion and exclusion criteria.Results A total of 18 articles were included,including 4 guidelines,1 expert consensus,2 nursing programs,2 systematic reviews,3 Meta analyses,1 case-control study,and 5 RCTs.The evidence of NICU neuromodulation assisted ventilation neonatal position management was summarized from five aspects:position and risk assessment,position placement during neonatal resuscitation and its operating points,position conversion during neonatal NAVA and its operating points,position management in special diseases or situations,use of position aids,and skin protection,the best evidence was formed.Conclusion This study summarizes the best evidence for neonatal position management of NICU neuromodulation assisted ventilation,and standardizes the neonatal body of NICU neuromodulation assisted ventilation.

关 键 词：NICU 神经调节辅助通气 新生儿 体位管理 最佳证据总结 

分 类 号：R473.72[医药卫生—护理学]