成人急性骨筋膜室综合征早期评估和管理的最佳证据总结  

Evidence summary of early assessment and management for adults with acute compartment syndrome

作　　者：陈智灵 陈唐瑜 钱会娟 韦小梅 万昌丽[3] 胡三莲 CHEN Zhiling;CHEN Tangyu;QIAN Huijuan;WEI Xiaomei;WAN Changli;HU Sanlian

机构地区：[1]上海交通大学医学院附属第六人民医院护理部,上海市200025 [2]上海交通大学护理学院 [3]上海长征医院骨科

出　　处：《中华护理杂志》2023年第16期2004-2011,共8页Chinese Journal of Nursing

基　　金：上海交通大学医学院2021年护理学科人才队伍建设项目(SJTUHLXK2021);上海市护理学会2021年度团体标准项目(2021-TBLX-03)。

摘　　要：目的遴选并汇总成人急性骨筋膜室综合征患者早期评估和管理的最佳证据,为进一步规范临床实践提供循证依据。方法根据证据金字塔“6S”模型,系统检索英国国家卫生与临床优化研究所网站、加拿大安大略注册护士协会网站、苏格兰学院间指南网、国际指南网、新西兰指南库、医脉通、中华医学会网站、美国骨科医师学会网站、美国骨科创伤学会网站、英国骨科协会网站、英国和爱尔兰麻醉医师协会网站、Cochrane Library、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、PubMed、Embase、Web of Science、CINAHL、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中的指南、专家共识、最佳实践、系统评价,检索时限为建库至2022年11月,2名接受过循证研究培训的研究者对纳入文献进行质量评价后,提取和整合证据。结果共纳入10篇文献,包括7篇指南、1篇系统评价、1篇最佳实践、1篇专家共识。汇总了包括评估时机、评估内容、筋膜室内压力监测、干预措施4个方面的24条证据。结论该研究总结的最佳证据为成人骨筋膜室综合征患者早期评估和管理提供了依据,临床护理人员在转化证据时应结合患者特点和证据应用场景,进一步规范成人急性骨筋膜室综合征患者早期评估和管理流程,以改善急性骨筋膜室综合征患者的临床结局。Objective To search and select the best evidence for early assessment and management of adult patients with acute compartment syndrome,in order to provide the evidence for further standardization of clinical practice.Methods Based on the“6s”model of the evidence pyramid,we retrieved the National Institute of Clinical Medicine(NICE),Registered Nurses’Association of Ontario(RNAO),Scottish Intercollegiate Guidelines Network(SIGN),Guidelines International Network(GIN),New Zealand Guidelines Database(NZGG),Medlive,Chinese Medical Association,American Academy of Orthopaedic Surgeons(AAOS),American Orthopaedic Trauma Society(OTA),British Orthopaedic Association(BOA),Association of Anesthesiologists of Great Britain and Ireland(AAGBI),Joanna Briggs Institution(JBI),The Cochrane Library,Pubmed,Embase,Web of Sciemce,CINAHL,CNKI,Wanfang Database,VIP Database,CMB,and collected relevant guidelines,expert consensuses,best practice and systematic reviews.2 researchers who have received evidence-based research training extracted and integrated the evidence after quality evaluation of the included literature.Results A total of 10 papers were included,involving 7 guidelines,1 expert consensus,1 best practice,and 1 systematic review.A total of 24 pieces of evidence including 8 dimensions were summarized,namely the occasion of assessment,assessment content,intracompartment pressure assessment,and interventions.Conclusion The best evidence for adults with acute compartment syndrome can provide references for clinical nurses to standardize the early assessment and management of adults with acute compartment syndromes and improve the outcomes,but the best evidence should be selected according to the patient's characteristics and evidence application environment.

关 键 词：筋膜间隔综合征 创伤 胫骨骨折 循证护理学 

分 类 号：R473.6[医药卫生—护理学]