成人烧伤患者创面现场急救处理的最佳证据总结  

Summary of the best evidence for emergency wound management in adult burn patients

作　　者：刘国帧 蒋琪霞 孙琳 王雅婧 Liu Guozhen;Jiang Qixia;Sun Lin;Wang Yajing(Medical School of Nanjing University,Nanjing 210008,China;Department of Burn and Plastic Surgery,Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,China;Department of Casualty Management,Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,China)

机构地区：[1]南京大学医学院,南京210008 [2]南京大学医学院附属金陵医院/东部战区总医院烧伤整形科,南京210002 [3]南京大学医学院附属金陵医院/东部战区总医院伤病员管理科,南京210002

出　　处：《创伤外科杂志》2023年第11期856-862,875,共8页Journal of Traumatic Surgery

基　　金：军队卫勤保障创新能力生成专项课题基金(20WQ027)。

摘　　要：目的 检索、评价和总结成人烧伤患者创面现场急救处理的最佳证据,为临床实践提供依据。方法 系统检索BMJ Best Practice、UpToDate、Cochrane Library、国际指南协作网、苏格兰院际指南网、医脉通、国际烧伤协会、美国烧伤协会、英国烧伤协会、PubMed、Web of Science、知网、万方等数据库以及指南网站及专业协会中关于成人烧伤患者创面现场急救处理的相关证据,包括指南、专家共识、证据总结及系统评价。检索时限为建库—2022年10月28日。由2名接受过循证方法学培训的研究人员独立进行文献阅读和质量评价,并提取证据,按照澳大利亚乔安娜布里格斯研究所文献证据评价等级进行分级,2名硕士指导老师全程督导研究质量。结果 共纳入16篇文献,包括12篇指南及4篇专家共识,从热烧伤的终止燃烧进程、冷却烧伤创面、保暖患者、敷料覆盖、水疱处理及化学烧伤的评估、冲洗、敷料覆盖共8个方面形成28条最佳证据。结论 本研究总结的最佳证据可为临床急救处理成人烧伤患者创面提供循证依据。应用证据时需充分考虑具体的临床情境及患者意愿,科学处理创面,减轻烧伤患者创面深度,为后续治疗奠定基础。Objective To retrieve,evaluate,and summarize the best evidence for emergency management of wounds in adult burn patients,and to guide clinical practice.Methods Comprehensive searching was conducted in the databases of BMJ Best Practice,UpToDate,Cochrane Library,Guidelines International Network,Scottish Intercollegiate Guidelines Network,Medlive,International Society for Burn Injuries,American Burn Association,British Burn Association,PubMed,Web of Science,CNKI and Wanfang,to retrieve evidence related to emergency management of wounds in adult burn patients,including guidelines,consensus,evidence summaries and systematic reviews.The publication period was set as the beginning of the database to Oct.28,2022.Two researchers trained in evidence-based methodology conducted the literature reading and quality assessment independently.Then they extracted evidence and graded the evidence according to the Joanna Briggs Institute Levels of Evidence and Grades of Recommendation,with the help of two supervisors of master candidate to ensure the study quality.Results A total of 16 references,including 12 guidelines and 4 expert consensus,were included in this study,which summarized 28 best evidence in 8 areas:(1)burning process termination,(2)burn wound cooling,(3)patient warming,(4)dressing coverage,(5)blister management for thermal burns and(6)assessment,(7)irrigation and(8)dressing coverage for chemical burns.Conclusion All the 28 summarized evidence can provide corresponding levels of evidence for the emergency management of wounds in adult burn patients.Application of the evidence should take the actual clinical situation and patients willingness into consideration,so as to manage the burn wounds more reasonably and decrease the depth of burns.

关 键 词：烧伤 创面 急救 循证护理 

分 类 号：R644[医药卫生—外科学]