神经重症气管插管患者口腔黏膜压力性损伤预防及管理的最佳证据总结  

Summary of best evidence for the prevention and management of oral mucosal pressure injury in severe neurological patients with tracheal intubation

作　　者：张莹莹 徐博[1] 陈成[1] 朱蓓蓓[1] 张娟[1] 冯敏[1] 李明[1] 陶震楠 陈璐[1] Zhang Yingying;Xu Bo;Chen Cheng;Zhu Beibei;Zhang Juan;Feng Min;Li Ming;Tao Zhennan;Chen Lu(Neurosurgery Department,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

出　　处：《中华现代护理杂志》2024年第12期1587-1595,共9页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金青年项目(82203876)。

摘　　要：目的总结神经重症气管插管患者口腔黏膜压力性损伤(OMPI)预防和管理的最佳证据。方法检索国内外数据库、相关指南网站及专业学会网站中针对神经重症气管插管患者OMPI预防和管理相关证据,包括临床决策、指南、专家共识、证据总结、系统评价、临床实践。检索时限均为建库至2023年5月30日。由4名经过系统循证培训的研究人员进行文献质量评价及证据提取。结果共纳入15篇文献,包括指南2篇,证据总结3篇,临床决策1篇,专家共识3篇,系统评价3篇,临床实践3篇,从风险评估、口腔黏膜评估、口腔护理、气管插管管理、营养支持、组织培训6个方面总结出27条最佳证据。结论本研究遴选汇总了神经重症气管插管患者OMPI预防与管理的最佳证据,为临床医护人员预防和管理神经重症气管插管患者OMPI提供循证依据。Objective To summarize the best evidence for the prevention and management of oral mucosal pressure injury(OMPI)in severe neurological patients with tracheal intubation.Methods The clinical decisions,guidelines,expert consensus,evidence summary,systematic reviews,and clinical practice regarding the prevention and management of OMPI in severe neurological patients with tracheal intubation were searched in domestic and foreign databases,guideline websites,and professional association websites.The search period was from database establishment to May 30,2023.Four researchers who undergone systematic evidence-based training conducted literature quality evaluation and evidence extraction.Results A total of 15 articles were included,including three evidence summaries,three systematic reviews,two guidelines,three clinical practices,three expert consensus,and one clinical decision.A total of 27 pieces of best evidence were summarized from six aspects of risk assessment,oral mucosal assessment,oral nursing,tracheal intubation management,nutritional support,and organizational training.Conclusions The best evidence for the prevention and management of OMPI in severe neurological patients with tracheal intubation summarized provides evidence-based evidence for medical and nursing staff to prevent and manage OMPI in severe neurological patients with tracheal intubation.

关 键 词：循证护理 神经重症 气管插管 口腔黏膜压力性损伤 医疗器械相关压力性损伤 

分 类 号：R473.74[医药卫生—护理学]