PICU患儿谵妄非药物管理的证据总结  

Summary of evidence for non-pharmacological management of delirium in PICU patients

作　　者：左玲玲 何珊 左泽兰[1] 廖敏[1] Zuo Lingling;He Shan;Zuo Zelan;Liao Min(Department of PICU,Children′s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院重症医学科、国家儿童健康与疾病临床医学研究中心、儿童发育疾病研究教育部重点实验室、儿科学重庆市重点实验室,重庆400014

出　　处：《中国小儿急救医学》2023年第5期327-333,共7页Chinese Pediatric Emergency Medicine

基　　金：2021年重庆医科大学附属儿童医院护理学科院级科研课题(CHCQMU2021.07)。

摘　　要：目的检索、评价并总结PICU患儿谵妄管理的最佳证据,为临床医护人员对PICU谵妄患儿的管理提供循证依据。方法系统检索国内外指南网、协会网、相关原始文献数据库中有关PICU谵妄患儿管理的指南、临床决策、系统评价、证据总结、专家共识(意见)等。对文章进行筛选、质量评价以及内容提取,形成PICU患儿谵妄非药物管理的证据总结。结果最终纳入6篇文献,包括3篇指南、2篇系统评价、1篇专家意见。对纳入的文献进行证据的提取,最终形成了PICU谵妄患儿非药物管理的最佳证据总结,包括谵妄筛查(5条)、危险因素评估(3条)、谵妄的预防与管理策略(8条)、医护人员教育与科室规范化管理(4条)4个维度,共20条证据总结。结论该研究总结的证据可以为PICU医护人员对儿童谵妄的预防与管理提供借鉴。在临床运用时,需要结合具体的临床情景,对证据进行调适及改进,以提高证据运用的有效性。Objective To search and summarize the evidence for the non-pharmacological management of delirium of critically ill patients in PICU,and to provide evidence-based guidance for clinical practice.Methods According to the"6S"evidence pyramid model,we searched computerized decision support system,websites of guidelines,and databases,and obtained the guidelines,clinical decisions,systematic reviews,and evidence summaries.After screening the articles,two researchers independently appraise articles using validated tools,and finally formed the evidence summary of delirium non-pharmacological management of critically ill patients in PICU.Results Totally six articles were included for the evidence synthesis,including three guidelines,two systematic reviews,and one expert advice.Twenty pieces of evidence including four aspects were summarized,namely delirium screening,risk prediction,non-pharmacological prevention and management strategies,health care provider education and departmental standardization.Conclusion The evidence summarized in this study can provide a reference to health care professionals.When we apply this evidence in the clinical setting,we should adapt it accordingly to the specific clinical setting to improve the effectiveness of the evidence.

关 键 词：谵妄 儿科重症监护室 非药物管理 证据总结 

分 类 号：R725[医药卫生—儿科]