主动脉夹层术后低氧血症患者俯卧位通气管理的最佳证据  

Best evidence for prone position ventilation management in hypoxemic patients after aortic dissection surgery

作　　者：程晓凡 武文静 赵佳琪 蔚玲 张珊 白璐 CHENG Xiaofan;WU Wenjing;ZHAO Jiaqi;WEI Ling;ZHANG Shan;BAI Lu(School of Nursing,Shanxi University of Chinese Medicine,Jinzhong Shanxi 030619;Department of Critical Care Medicine,Shanxi Bethune Hospital,Taiyuan 030023;Center Department of Surgery,Shanxi Bethune Hospital,Taiyuan 030023;Department of Respiratory and Critical Care Medicine,Shanxi Provincial People’s Hospital,Taiyuan 030012,China)

机构地区：[1]山西中医药大学护理学院,山西晋中030619 [2]山西白求恩医院重症医学科,太原030023 [3]山西白求恩医院中心手术部,太原030023 [4]山西省人民医院呼吸与危重症医学科,太原030012

出　　处：《临床与病理杂志》2024年第10期1403-1412,共10页Journal of Clinical and Pathological Research

基　　金：新冠感染应急攻关科研专项(2023xg13)。

摘　　要：目的:目前关于主动脉夹层术后低氧血症患者俯卧位通气的管理尚未形成系统的循证方案。本研究检索、评价及总结主动脉夹层术后低氧血症患者俯卧位通气管理的相关证据,为临床规范主动脉夹层术后低氧血症患者俯卧位通气流程和预防并发症的发生提供循证依据。方法:基于证据金字塔“6S模式”检索各大数据库以及专业网站中与主动脉夹层术后低氧血症患者俯卧位通气相关的文献,包括临床决策、指南、专家共识、系统评价、随机对照试验(randomized controlled trial,RCT)等类型,研究者对纳入的文献进行质量评价和证据提取,并对其进行汇总。结果:共纳入20篇文献,包括1篇临床决策、7篇指南、5篇专家共识、2篇系统评价、4篇RCT和1篇类实验研究。总结出27条证据,涵盖评估、实施前准备、人员组织管理、实施期间管理和结束时机5个类别。结论:本研究总结的主动脉夹层术后俯卧位通气管理的证据全面且科学,可为临床医护人员规范俯卧位通气提供循证依据。Objective:Currently,there is no systematic evidence-based protocol for the management of prone position ventilation in hypoxemic patients after aortic dissection surgery.This study aims to retrieve,evaluate,and summarize the relevant evidence for prone position ventilation management in hypoxemic patients post-aortic dissection surgery,providing evidence for clinical standardization of prone position ventilation and prevention of complications.Methods:Based on the“6S model”of the evidence pyramid,a literature search was conducted across major databases and professional websites for studies related to prone position ventilation in hypoxemic patients after aortic dissection surgery,including clinical decisions,guidelines,expert consensus,systematic reviews,and randomized controlled trials(RCTs).The included studies were evaluated for quality,and evidence extracted and summarized.Results:A total of 20 articles were included,consisting of 1 clinical decision,7 guidelines,5 expert consensuses,2 systematic reviews,4 RCTs,and 1 quasi-experimental study.A total of 27 pieces of evidence were summarized,covering 5 categories:assessment,pre-implementation preparation,personnel organization and management,management during implementation,and timing for ending the procedure.Conclusion:The evidence summarized in this study for prone position ventilation management after aortic dissection surgery is comprehensive and scientific,providing an evidence-based foundation for clinical healthcare professionals to standardize prone position ventilation practices.

关 键 词：主动脉夹层 低氧血症 俯卧位通气 证据总结 循证护理学 

分 类 号：R47[医药卫生—护理学]