成人重症患者颅内压增高防控护理专家共识  

Expert consensus on the prevention and control of intracranial hypertension in adult critical illness

作　　者：中华护理学会重症护理专业委员会 刘芳[2] 王宇娇[3] 曹笑柏 高岚[3] 徐松柏[4] 米元元 孙红 苗凤茹 黎艳[8] 李虹彦[9] The Critical Care Professional Committee of the Chinese Nursing Association;LIU Fang;WANG Yujiao;CAO Xiaobai;GAO Lan;XU Songbai;MI Yuanyuan;SUN Hong;MIAO Fengru;LI Yan;LI Hongyan

机构地区：[1]不详 [2]首都医科大学宣武医院神经内科,北京市100053 [3]吉林大学第一医院神经内科 [4]吉林大学第一医院神经外科 [5]华中科技大学同济医学院附属协和医院重症医学科 [6]中国医学科学院北京协和医院组织处 [7]北京航天中心医院神经内科 [8]广西壮族自治区人民医院重症医学科 [9]吉林大学第一医院院长办公室

出　　处：《中华护理杂志》2024年第21期2606-2610,共5页Chinese Journal of Nursing

基　　金：吉林省科技发展计划项目(20220508087RC)。

摘　　要：目的编写“成人重症患者颅内压增高防控护理专家共识”(以下简称“共识”),以规范重症患者颅内压增高防控相关护理工作,改善患者临床结局。方法以循证实践为指引,检索国内外数据库中颅内压增高相关的指南、专家共识、系统评价、证据总结及原始研究等,检索时限为建库至2024年3月。评价、提取及汇总该领域高质量证据及建议,形成“共识”初稿。邀请27名专家进行2轮专家函询和8名专家进行2次专家论证会议,对初稿内容进行修改、完善,最终形成“共识”终稿。结果2轮函询问卷的有效回收率均为100%,专家权威系数均为0.884,判断系数均为0.964,熟悉程度均为0.804。2轮专家函询的肯德尔和谐系数分别为0.107和0.083(均P<0.05)。“共识”包括颅内压增高的识别、监测、防控策略、急救与护理4个方面。结论该“共识”具有较强的科学性,可为护士开展颅内压增高预防与护理工作提供参考。Objective The purpose of writing the“Expert consensus on the prevention and control of intracranial hypertension in adult critical illness”(here in after referred to as the"Consensus")aimed to standardize the nursing work related to the prevention and control of elevated intracranial pressure in adult critical illness,and prevent the occurrence of complications such as cerebral herniation.Methods Guided by evidence-based practice,domestic and foreign databases were searched for guidelines,expert consensuses,systematic evaluation,evidence summaries,and original research related to increased intracranial pressure.The search period is from database establishment to March 2024.The high-quality evidence and suggestions in the field was evaluated,extracted,and summarized to form a preliminary consensus.27 experts were invited to conduct 2 rounds of expert inquiry and 8 experts were invited to conduct 2 expert discussion meetings,to revise and improve the content of the initial draft,and to ultimately form a final consensus.Results The effective response rates for both rounds of inquiry questionnaires were 100%,with expert authority coefficients of 0.884,judgment coefficients of 0.964,and familiarity levels of 0.804.The Kendall harmony coefficients for 2 rounds of inquiry were 0.107 and 0.083(P<0.01),respectively.The consensus includes 4 aspects,including identification,monitoring,prevention and control strategies,emergency treatment and care for increased intracranial pressure.Conclusion This“Consensus”has strong scientific validity and can provide reference basis for nurses to carry out prevention and control of intracranial pressure increase.

关 键 词：重症患者 颅内压 防控 护理 专家共识 

分 类 号：R473[医药卫生—护理学]