老年髋部骨折患者围术期容量管理的最佳证据总结  

Summary of evidences perioperative in fluid management of elderly patients with hip fracture

作　　者：李叔寒 王治乾[2] 栗维宁 陈彩真[3] 周春霞[4] 郑丽[5] 李秀婷[2] 张秀果[3] Li Shuhan;Wang Zhiqian;Li Weining;Chen Caizhen;Zhou Chunxia;Zheng Li;Liu Xiuting;Zhang Xiuguo(Hebei Medical University,Shijiazhuang,050030,China;a.Traumatic Emergency Centre,the Third Hospital,Hebei Medical University,Shijiazhuang,050051,China;Department of Nursing Administration,the Third Hospital,Hebei Medical University,Shijiazhuang,050051,China;Cardiovasology,the Third Hospital,Hebei Medical University,Shijiazhuang,050051,China;Department of Joint Surgery,the Third Hospital,Hebei Medical University,Shijiazhuang,050051,China)

机构地区：[1]河北医科大学,河北石家庄050030 [2]河北医科大学第三医院创伤急救中心,河北石家庄050051 [3]河北医科大学第三医院护理部,河北石家庄050051 [4]河北医科大学第三医院心血管内科,河北石家庄050051 [5]河北医科大学第三医院关节外科,河北石家庄050051

出　　处：《现代临床护理》2024年第5期57-64,共8页Modern Clinical Nursing

基　　金：河北省卫健委医学科学研究课题项目,项目编号为20240084;河北省卫生行业项目,项目编号为20201007。

摘　　要：目的检索、评价和整合老年髋部骨折患者围术期容量管理的最佳证据,为临床医护理人员提供依据。方法按照“6S”证据模型,系统检索国内外数据库和网站。数据库包括:BMJ Best Practice,UpToDate,临床实践指南美国骨科医师协会、美国骨与矿物质研究协会、澳大利亚和新西兰髋部骨折登记处、欧洲创伤与急诊外科学会、英国国家卫生与临床优化研究所网站、苏格兰校际指南网、乔安娜布里格斯研究所、Cochrane Library,CINAHL,Embase,PubMed,Web of Science,中国知网、万方数据库、维普数据库、循证卫生保健中心数据库、医脉通、中国生物医学文献数据库及骨科相关网站。检索关于老年髋部骨折患者围术期容量管理的证据,包括指南、临床决策、最佳实践、专家共识系统评价及原始研究,检索时限为建库至2022年8月。由2名研究人员对文献质量进行评价,并对证据进行提取、评价与整合,独立完成文献质量评价。结果共纳入15篇文献,包括3篇临床决策、1篇最佳实践、2篇指南、7篇专家共识、2篇系统评价,从多学科团队协作、动态评估和监测液体状态、液体复苏、术中和术后容量管理方案、健康宣教7个方面总结证据。结论本研究汇总老年髋部骨折患者围术期容量管理的最佳证据,可为医护人员提供循证依据,医护人员应充分结合临床情景,动态评估液体容量状态变化,制定个性化的容量管理策略,改善患者预后。Objective To retrieve,analyse and integrate the best evidences in perioperative fluid management for elderly patients with hip fracture,therefore to provide references for patient care.Methods Following the 6S evidence model,databases and websites were searched to collect the evidences on perioperative fluid management of elderly patients with hip fracture.The searched databases including BMJ Best Practice,UpToDate,AAOS Clinical Practice Guidelines,ASBMR,ANZHFR,ESTES,NICE,SIGN,JBI,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,Wanfang Data,VIP database,CEBM Database,Medive,China Science and Technology Journal Database,SinoMed,and other websites about orthopaedics.The searched literatures included guidelines,clinical decision-making,best practices,expert consensus and systematic reviews.The time span for the published literatures was from the inception of the databases and websites to August 2022.Two researchers independently completed quality evaluations of the retrieved literatures,as well as extraction,assessment and integration of the abstracted evidences.Results A total of 15 articles were included,they were 2 guidelines,3 clinical decision-makings,1 best practice,7 expert consensus,and 2 systematic reviews.Thirty pieces of evidence were summarised from 7 aspects,covering multidisciplinary team collaboration,dynamic assessment and monitoring of fluid status,fluid resuscitation,fluid management before and after the surgery and health education.Conclusions This study summarised the best evidences in perioperative fluid management for elderly patients with hip fracture.The evidences provide an evidence-based solution which will enable the healthcare workers to fully combine the clinical scenarios,evaluate changes in fluid volume status dynamically,develope personalised fluid management strategies and improve patient outcomes.

关 键 词：髋部骨折 容量管理 老年 围术期 证据总结 

分 类 号：R473.6[医药卫生—护理学]