骨科大手术术中静脉血栓栓塞症预防的最佳证据总结  

The best evidence summary for intraoperative venous thromboembolism prevention in major orthopaedic surgery

作　　者：邓亚洁 马雨玲 梅迎雪[2] 徐芳成琳 余永琴 李金萍[2] DENG Yajie;MA Yuling;MEI Yingxue;XU Fangchenglin;YU Yongqin;LI Jinping(School of Nursing,Ningxia Medical University,Ningxia 750004 China)

机构地区：[1]宁夏医科大学护理学院,750004 [2]宁夏回族自治区人民医院(宁夏医科大学附属自治区人民医院),750002

出　　处：《全科护理》2024年第24期4560-4565,共6页Chinese General Practice Nursing

基　　金：宁夏自然科学基金项目,编号:2023AAC03490。

摘　　要：目的:检索、评价、整合国内外骨科大手术术中静脉血栓栓塞症预防的证据,为手术室医护人员进行术中静脉血栓栓塞症预防提供循证依据。方法:依照证据资源“6S”金字塔模型自上而下检索临床决策系统、指南网、英文数据库、中文数据库、国内外骨外科和血液科专业协会网站中关于骨科大手术术中静脉血栓栓塞症预防的相关文献,对纳入文献进行方法学质量评价后根据主题进行证据提取和汇总。结果:共纳入26篇文献,包括1篇临床决策、2篇证据总结、5篇指南、6篇专家共识和12篇系统评价。最终形成风险评估、基本预防、麻醉方式、止血带的使用、机械预防和日间手术6个循证主题和30条证据。结论:骨科大手术术中静脉血栓栓塞症预防的最佳证据可为临床开展循证实践提供依据。医护人员进行证据转化时应结合手术室实际情景、参与手术操作医护人员的临床经验和病人意愿,充分考虑证据的可行性,以制订适合且便于术中实施的静脉血栓栓塞症预防方案。Objective:To retrieve,evaluate and integrate the evidence of intraoperative venous thromboembolism prevention in major orthopaedic surgery,and to give operating theatre healthcare professionals an evidence-based basis for intraoperative venous thromboembolism prevention.Methods:According to the"6S"model,literature related to intraoperative venous thromboembolism prophylaxis in major orthopaedic surgery was searched from clinical decision-making systems,guideline websites,English databases,Chinese databases,websites of domestic and international orthopaedic surgery and hematology specialty websites.Results:A total of 26 papers were included,including 1 clinical decision support,2 evidence summarizes,5 guidelines,6 expert consensus and 12 systematic reviews.Thirty items of evidence were summarized into the following 6 categories:risk assessment,basic prevention,anesthetic modalities,tourniquet using,mechanical prophylaxis and day surgery.Conclusions:The best evidence for intraoperative venous thromboembolism prevention in major orthopaedic surgery can provide a basis for clinical evidence-based practice.When translating evidence,healthcare professionals should consider the operating theatre context,the healthcare professionals′experience,and the patients′wishes,and fully consider the feasibility of the evidence in order to develop a venous thromboembolism prevention program that is suitable and easy to implement intraoperatively.

关 键 词：骨科大手术 静脉血栓栓塞症 证据总结 循证护理学 

分 类 号：R472.3[医药卫生—护理学]