儿童脓毒症休克液体复苏管理的最佳证据总结  

Fluid resuscitation management in children with septic shock:a summary of the best evidence

作　　者：胡艳丽 陈欧[1] 胡阔娜 吕芳芳 徐伟娟 HU Yanli;CHEN Ou;HU Kuona;LYU Fangfang;XU Weijuan(School of Nursing and Rehabilitation,Shandong University/Shandong Provincial Hospital Affiliated to Shandong First Medical University,Shandong 250021 China)

机构地区：[1]山东大学护理与康复学院,250021 [2]山东第一医科大学附属省立医院,250000

出　　处：《全科护理》2025年第3期409-414,共6页Chinese General Practice Nursing

基　　金：山东省自然科学基金面上项目,编号:ZR2020MH006。

摘　　要：目的:总结儿童脓毒症休克液体复苏管理的最佳证据,为临床实践提供参考依据。方法:系统检索临床决策支持系统、指南网、专业协会网、循证数据库和综合数据库中关于儿童脓毒症休克液体复苏的相关临床决策、指南、证据总结、循证实践、专家共识、系统评价和Meta分析,检索时限为建库至2024年5月1日。由2名学习过循证方法的研究者独立进行文献质量评价,并对纳入文献进行证据提取、整合和分级;成立专家小组对证据进行强度推荐。结果:共纳入13篇文献,包括临床决策4篇、指南4篇、专家共识4篇、证据总结1篇。从脓毒症休克诊断标准、早期筛查识别、液体复苏策略、复苏的评估与监测、质量促进5个方面总结出17条证据。结论:该研究总结了儿童脓毒症休克液体复苏管理的最佳证据,建议临床参考本研究构建本土化实践方案,不断更新最佳证据,提升治疗护理水平。Objective:To summarize the best evidence for fluid resuscitation management in children with septic shock and provide reference for clinical practice.Methods:Related clinical decision support systems,guidelines,evidence summaries,evidence-based practices,expert consensus,systematic reviews,and meta-analyses on fluid resuscitation in children with septic shock were retrieved systematically from the clinical decision support system,guidelines website,professional association website,evidence-based database,and comprehensive database.The search period was from database establishment to May 1,2024.Two researchers who had learned evidence-based methods independently evaluated the quality of the literature,extracted,integrated and graded the included literature.An expert group was established to recommend the strength of the evidence.Results:A total of 13 papers were included,including 4 clinical decision articles,4 guidelines,4 expert consensus articles,and 1 evidence summary.A total of 17 pieces of evidence were summarized from five aspects:diagnosis of septic shock,early screening and identification,fluid resuscitation strategy,assessment and monitoring of resuscitation,and quality promotion.Conclusions:This study summarized the best evidence for fluid resuscitation management of septic shock in children,and suggested that clinical reference should be made in this study to build a localized practice plan,constantly update the best evidence,and improve the level of treatment and nursing.

关 键 词：儿童 脓毒症 脓毒症休克 证据总结 循证护理 

分 类 号：R473.72[医药卫生—护理学]