回肠造口患者高排量及脱水预防管理的证据总结  

Evidence summary on preventive management of high output and dehydration in ileostomy patients

作　　者：许莹莹 裴丹丹 陈莉[1] 朱欢欢[1] 徐美玲[1] 翁亚娟 沈晓菲[1] XU Yingying;PEI Dandan;CHEN Li;ZHU Huanhuan;XU Meiling;WENG Yajuan;SHEN Xiaofei(Department of General Surgery,Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing,Jiangsu,210009;Nursing Department,Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing,Jiangsu,210009)

机构地区：[1]南京大学医学院附属鼓楼医院普外科,江苏南京210009 [2]南京大学医学院附属鼓楼医院护理部,江苏南京210009

出　　处：《实用临床医药杂志》2024年第23期126-131,共6页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金面上项目(81970500);2021年南京鼓楼医院立项护理科研课题(SB210-4)。

摘　　要：目的检索、评价并总结国内外关于回肠造口患者高排量及脱水预防管理的证据。方法基于“6S”证据模型,自上而下检索关于回肠造口患者高排量及脱水预防管理的证据,检索的数据库包括BMJ最佳临床实践、UpToDate、美国国立指南库(NGC)、英国国家卫生与临床优化研究所(NICE)、苏格兰校际指南网络(SIGN)、加拿大安大略注册护士协会网(RNAO)、国际伤口造口失禁护理协会(WOCNS)、世界造口治疗师协会(WCET)、医脉通临床指南网、JBI循证卫生保健中心数据库(JBI)、Cochrane Library、Embase、PubMed、Web of Science、中国知网、万方数据库、中国生物医学文献数据库和维普数据库,检索时间范围为2019年1月—2024年4月。结果检索并筛选后共纳入13篇文献,包括2篇指南、2篇专家共识、4篇系统评价、4篇证据总结和1篇临床决策。对纳入文献的内容进行翻译、汇总和整理后,围绕回肠造口高排量定义与危险因素、回肠造口高排量相关预防管理策略、回肠造口高排量脱水相关预防管理策略、回肠造口术后高排量及脱水预防随访策略4个项目,共形成11个类别的19条证据。结论基于“6S”证据模型总结的回肠造口患者高排量及脱水预防管理证据,可为医护人员及医疗决策者的临床实践提供参考依据,从而提升护理质量,降低患者再入院率。Objective To retrieve,evaluate,and summarize evidence on preventive management of high output and dehydration in ileostomy patients from both domestic and international sources.Methods Based on the"6S"evidence model,a top-down approach was employed to retrieve evidence on prevention and management of high output and dehydration in ileostomy patients.Databases searched included BMJ best practice,UpToDate,National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),Registered Nurses'Association of Ontario(RNAO),Wound Ostomy and Continence Nurses Society(WOCNS),World Council of Enterostomal Therapists(WCET),Medlive Clinical Guidelines website,Joanna Briggs Institute(JBI),Cochrane Library,Embase,PubMed,Web of Science,CNKI,Wanfang Data,China Biology Medicine(CBM),and VIP Database.The search period was from January 2019 to April 2024.Results A total of 13 articles were included after retrieval and screening,comprising 2 guidelines,2 expert consensuses,4 systematic reviews,4 evidence summaries,and 1 clinical decision aid.After translation,summarization,and organization of the included articles,19 pieces of evidence across 11 categories were formulated,focusing on four items:definition and risk factors of high output in ileostomy,prevention and management strategies related to high output in ileostomy,prevention and management strategies related to dehydration in high-output ileostomy,and follow-up strategies for prevention of high output and dehydration after ileostomy surgery.Conclusion The evidence summarized based on the"6S"evidence model for prevention and management of high output and dehydration in ileostomy patients can provide a reference for clinical practice among healthcare professionals and medical decision-makers,thereby enhancing nursing quality and reducing patient rehospitalization rates.

关 键 词：肠造口 高排量 脱水 证据总结 循证护理 术后管理 

分 类 号：R473.6[医药卫生—护理学] R735.3[医药卫生—临床医学] R319