中心静脉导管持续引流肿瘤相关性腹水管理的最佳证据总结  

Evidence summary on management of tumor associated ascites drainage with a central venous catheter

作　　者：颜恺然 王丹若 逄天宇 孙露露 袁玲 Yan Kairan;Wang Danruo;Pang Tianyu;Sun Lulu;Yuan Ling(School of Nursing,Nanjing University of Traditional Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学护理学院,江苏南京210023 [2]南京大学医学院附属鼓楼医院肿瘤科 [3]南京中医药大学鼓楼临床医学院肿瘤科

出　　处：《护理学杂志》2024年第8期59-63,共5页Journal of Nursing Science

基　　金：南京鼓楼医院护理科研课题项目(2023-A1656)。

摘　　要：目的检索、评价并总结中心静脉导管持续引流肿瘤腹水管理的最佳证据,为临床优化导管引流管理提供参考。方法系统检索UptoDate、BMJ最佳临床实践、JBI循证卫生保健中心数据库、PubMed、Cochrane Library、医脉通、中国知网等数据库中关于中心静脉导管持续引流肿瘤相关性腹水导管的指南、系统评价、专家共识、临床决策和随机对照试验等。2名研究者进行文献质量评价和资料提取,并结合专业人员的判断,进行证据汇总。结果共纳入12篇文献,其中临床决策1篇,专家共识3篇,系统评价1篇,随机对照试验6篇,队列研究1篇。汇总了关于中心静脉导管引流肿瘤腹水管理的23条证据,包括评估、腹水引流调节装置、导管固定、敷料、冲管和封管、导管堵塞处理、腹水渗漏预防处理、并发症处置及健康教育9个方面。结论总结中心静脉导管持续引流肿瘤相关性腹水管理的证据,为临床医护人员实施中心静脉导管引流腹水以及优化导管引流管理提供循证依据。Objective To systematically retrieve,evaluate,and synthesize the best evidence regarding management of tumor associated ascites drainage with a central venous catheter(CVC).Methods Such databases such as UptoDate,BMJ Best Clinical Practice,JBI Evidence-Based Health Care Center database,PubMed,Cochrane Library,MedLive,and CNKI,were searched for guidelines,systematic reviews,expert consensus reports,clinical decisions,and randomized controlled trials on continuous drainage of tumor-associated ascites with a CVC.Two researchers conducted quality appraisal of the included literature,extracted necessary information,and utilized professional judgment to summarize the evidence.Results Totally,12 papers,including 1 clinical decision,3 expert consensus reports,1 systematic review,6 randomized controlled trials,and 1 cohort study,were included,yielding 23 pieces of evidence in CVC drainage for tumor associated ascites factored into 9 aspects:assessment,tweaking device for ascites drainage,catheter fixation,dressing,flushing and sealing,management of catheter blockage,prevention and management of ascites leakage,complication management and health education.Conclusion The best evidence regarding management of tumor associated ascites drainage with a CVC,could provide evidence-based support for clinical workers to perform the procedure,and optimize drainage management.

关 键 词：中心静脉导管 腹水 肿瘤 肿瘤相关性腹水 腹水引流 管理 证据总结 循证护理 

分 类 号：R473.73[医药卫生—护理学]