经静脉临时心脏起搏器置入术患者术肢管理专家共识  

Expert consensus on limb management of patients with transvenous temporary cardiac pacing

作　　者：中华护理学会放射介入护理专业委员会 刘华芬[2] 周佳莉[3] 黄峥[7] 张智霞 梁景煜[2] 蔡忠香[4] 陈付红[9] 周云英[10] 鲜于云艳[5] 闫琳 喻惠丹[12] 彭会珍[13] 朱剑[14] 田园[15] 张燕[6] 蒋和俊 张素[17] Radioactive Interventional Nursing Professional Committee of Chinese Nursing Association;LIU Huafen;ZHOU Jiali;HUANG Zheng;ZHANG Zhixia;LIANG Jingyu;CAI Zhongxiang;CHEN Fuhong;ZHOU Yunying;XIANYU Yunyan;YAN Lin;YU Huidan;PENG Huizhen;ZHU Jian;TIAN Yuan;ZHANG Yan;JIANG Hejun;ZHANG Su

机构地区：[1]不详 [2]武汉大学人民医院心血管医院心脏介入中心,武汉市430060 [3]武汉大学人民医院心血管医院心血管科,武汉市430060 [4]武汉大学人民医院心血管医院护理部,武汉市430060 [5]武汉大学人民医院心血管医院党委组织部,武汉市430060 [6]武汉大学人民医院心血管医院东院心导管室,武汉市430060 [7]郑州大学第一附属医院护理部 [8]山西省临汾市中心医院院办公室 [9]厦门大学附属第一医院护理部 [10]江西省人民医院心血管医院介入中心 [11]中国医学科学院阜外医院护理部 [12]武汉大学护理学院 [13]河南省人民医院介入导管室 [14]南昌大学第二附属医院综合介入室 [15]首都医科大学附属北京安贞医院心律失常中心二病区 [16]中南大学湘雅二院心脏介入诊疗中心 [17]北京大学人民医院呼吸与危重症医学科

出　　处：《中华护理杂志》2024年第13期1581-1583,共3页Chinese Journal of Nursing

摘　　要：目的形成经静脉临时心脏起搏器置入术患者术肢管理专家共识(以下简称“共识”),规范临床经静脉临时心脏起搏器置入术患者术肢管理工作,减少术肢相关并发症的发生。方法运用循证方法,检索、评价和汇总相关证据,提取推荐意见和研究结论,进行证据等级划分、确定证据推荐级别,形成“共识”初稿。2023年12月—2024年1月,通过2轮专家函询和4次专家论证会,对初稿进行修订并形成“共识”终稿。结果共16名专家参与函询,专家积极程度系数为100%,专家权威系数为0.847、0.836,每个指标的重要性赋值均>3.80分,变异系数均<0.21,2轮专家函询的肯德尔和谐系数分别为0.372、0.314(P<0.01)。该“共识”涵盖经静脉临时心脏起搏器置入术前、术中及术后3个环节,涉及术前准备;术中体位管理、导线固定;术后导线固定、体位管理、活动与制动、翻身与转运、床旁术肢交接、拔管后护理、预防术肢深静脉血栓形成、预防感染等11个方面。结论该“共识”具有较强的科学性,可规范临床经静脉临时心脏起搏器置入术患者的术肢管理。Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing,standardize the limb management of patients with transvenous temporary cardiac pacing,and reduce complications related to the limb.Methods Using evidence-based methods,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality,and then the first draft of the consensus was formed.From December 2023 to January 2024,through 2 rounds of expert consultation and 4 rounds of expert meetings,the content was adjusted and the consensus was reached.Results Totally 16 experts participated in the consultation.The positive coefficient is 100%;the authoritative coefficient is 0.847 and 0.836;the average value of each index is more than>3.8;the coefficient of variation is less than 0.21.The Kendall’s harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314,respectively,which were statistically significant.The consensus covers the preoperative,intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing.Totally 11 themes were involved,including the preoperative preparation,position and catheter fixation in operation,position and catheter fixation in postoperative,activity,turn and transfer,duty shift on limb,nursing care after withdrawal of the catheter,prevention of deep vein thrombosis of the operative limb and prevent infection.Conclusion The consensus is highly scientific,and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.

关 键 词：经静脉临时心脏起搏 术肢管理 护理 专家共识 

分 类 号：R473.5[医药卫生—护理学]