间歇性充气加压用于成人重症患者下肢静脉血栓预防的证据总结  

Summary of evidence for intermittent pneumatic compression for lower limb venous thromboprophylaxis in critically Ill adult patients

作　　者：徐博[1] 赵振华 邢星敏 季翠玲[1] 袁萍 XU Bo;ZHAO Zhenhua;XING Xingmin;JI Cuiling;YUAN Ping(Department of Neurosurgery,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Critical.Medicine Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院神经外科,南京210008 [2]南京大学医学院附属鼓楼医院重症医学科,南京210008

出　　处：《当代护士（上旬刊）》2023年第12期1-5,共5页Modern Nurse

基　　金：复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202121)。

摘　　要：目的通过检索、评价并总结间歇性充气加压(intermittent pneumatic compression,IPC)用于成人重症患者下肢静脉血栓预防的相关文献,为临床工作改进提供依据。方法通过检索相关数据库如BMJ最佳临床实践、UpToDate临床决策支持系统、英国国家卫生和临床技术优化研究所(National Institute for Health and Clinical Excellence,NICE)、苏格兰校际指南网络(Scottish Intercollegiate Guidelines Network,SIGN)、加拿大安大略注册护士协会网站(Registered Nurses′Association of Ontario,RNAO)、美国临床指南网(National Guideline Clearinghouse,NGC)、乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、Cochrane Library、PubMed和中国生物医学文献服务系统(Chinese Biomedical Literature Service System,SinoMed)、美国血液学会(American Society of Hematology,ASH)等。检索其中关于间歇性充气加压用于成人重症患者下肢静脉血栓防治方面相关的证据,包括临床决策、临床实践指南、证据总结、专家共识、系统评价等,对证据进行方法学质量评价,再按照主题提取与汇总证据资料。结果根据纳入标准共筛选出12篇文献,通过阅读、提取和汇总,整理了关于间歇性充气加压装置使用前评估患者、使用适应证、使用禁忌证、启动时机、实施前准备、充气方法、使用时长、停止时机、过程观察、并发症观察和文件记录11个主题的19条证据。结论通过证据总结,可帮助一线护理人员更高效地获取并理解和掌握证据,从而进一步规范IPC的临床使用,促进建立标准化IPC使用管理流程,提高IPC干预效果,防止患者的下肢静脉形成血栓,提高护理质量。Objective To search,evaluate and integrate the relevant evidence of intermittent pneumatic compression(IPC)for the prevention of lower limb venous thrombosis in adult critically ill patients,and to provide the basis for clinical work.Methods The BMJ Best Clinical Practice,UptoDate Clinical Decision System,Registered Nurses Association of Ontario(RNAO),National Institute for Health and Clinical Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),National Guideline Clearinghouse(NGC),JBI evidence-based health care database,Corhrane Library,PubMed,and Chinese Biomedical Literature Service System(SinoMed)websites were searched by computer system for evidence related to intermittent pneumatic compression for lower limb venous thrombosis prevention in adult critically ill patients,including clinical decisions,recommended practices,evidence summary,clinical practice guidelines,expert consensus,and systematic review.After methodological quality evaluation,the evidence was extracted and summarized according to the theme.Results Nineteen evidence were screened according to the inclusion criteria,including 5 expert consensus,1 group standard,4 clinical guidelines,and 2 evidence summary.Twenty pieces of evidence involving 11 topics:pre-use patient assessment,indications for use,contraindications for use,timing of initiation,preparation before implementation,method of inflation,length of use,timing of cessation,observation of complications,and documentation of intermittent pneumatic compression devices were summarized by reading,extracting,and categorizing.Conclusion Medical staff should follow the best evidence of intermittent pneumatic compression for the prevention of lower limb venous thrombosis in adult critically ill patients,standardize the use of intermittent pneumatic compression device,prevent lower limb venous thrombosis in patients and improve the quality of care.

关 键 词：成人 间歇性充气加压 下肢静脉血栓 预防 循证护理 证据总结 

分 类 号：R473[医药卫生—护理学]