基于指南和临床决策的成年住院患者手术部位感染预防的证据分析  

Evidence summary of surgical site infection prevention in adult inpatients based on guidelines and clinical decision making

作　　者：雷清梅 欧丽珊 凌冬兰 程秋辰 张时真 王兆涛 颜红波[1] LEI Qingmei;OU Lishan;LING Donglan;CHENG Qiuchen;ZHANG Shizhen;WANG Zhaotao;YAN Hongbo(The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院,广东广州510260

出　　处：《现代医院》2024年第2期222-226,共5页Modern Hospitals

基　　金：广州市卫生健康科技一般引导项目(20231A010054)。

摘　　要：目的总结成年住院患者手术部位感染(surgical site infection,SSI)预防的最佳证据,为临床护理实践提供预防SSI的循证建议。方法根据6S证据金字塔,依次系统检索国内外循证资源库、指南网、数据库和相关专业学会网站关于成年住院患者SSI预防的相关证据,检索时限为建库至2023年9月30日。由4名研究者分别对纳入指南进行文献质量评价,由2名研究者分别对其他文献类型进行质量评价及证据级别评定。结果本研究共纳入12篇文献,其中临床决策6篇,临床指南6篇,从诊断、临床症状、影响因素、患者预防策略、医护预防策略、术中术后处理、咨询与教育7个方面汇总了30条最佳证据。结论降低SSI发生率不能采取单一措施,应基于证据制定规范化的感染预防管理方案,临床医护人员应用证据时应结合临床实际情况和患者意愿,制定规范的预防SSI的工作流程。Objective To provide evidence-based references for the prevention of surgical site infection(SSI)by summarizing the best evidence for the prevention of SSI in adult inpatients.Methods The‘6S’evidence resource pyramid model was used to systematically search the related evidence in domestic and foreign databases,guideline websites,and academic society websites from the inception of the database to September 30,2023.Four researchers evaluated the quality of the included guidelines,and two researchers independently evaluated the quality of other types of literature and rated the level of evidence.Results A total of 12 articles were included,including 6 clinical decision making and 6 clinical guidelines.Thirty best items of the evidence were summarized from 7 aspects:diagnosis,clinical symptoms,influencing factors,patient prevention strategies,preventive strategies for medical staff,intraoperative and postoperative treatment,and consultation and education.Conclusion Clinical staff should develop a standardized management plan for infection prevention based on corresponding evidence to reduce the incidence of SSI instead of taking a single measurement.Moreover,they need to formulate a standardized work process for preventing SSI based on the clinical practice and patients’preference.

关 键 词：手术部位感染 预防 证据总结 循证护理学 

分 类 号：R473.6[医药卫生—护理学] R197.323.4[医药卫生—临床医学]