脑出血患者静脉血栓栓塞症预防和管理的最佳证据总结  

Summary of the Best Evidence for the Prevention and Management of Venous Thromboembolism in Patients with Intracerebral Hemorrhage

作　　者：杨博 梁恒娟 黄小红[2] YANG Bo;LIANG Hengjuan;HUANG Xiaohong(Shenzhen Clinical School of Medicine,Guangzhou University of Chinese Medicine,Shenzhen 518000,China;Department of Nursing,Shenzhen Longgang Central Hospital,Shenzhen 518000,China)

机构地区：[1]广州中医药大学深圳临床医学院,广东省深圳市518000 [2]广东省深圳市龙岗中心医院护理部,518000

出　　处：《实用心脑肺血管病杂志》2025年第4期19-24,37,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：深圳市卫生健康菁英人才培养计划(JY2021XKG077)。

摘　　要：目的 通过回顾相关文献,总结脑出血(ICH)患者静脉血栓栓塞症(VTE)预防和管理的最佳证据。方法 依据PIPOST模型构建循证问题框架,基于“6S”证据模型,自上而下,计算机系统检索UpToDate、国际指南协作网、英国国家卫生与临床优化研究所网站、苏格兰校际指南网、美国国立指南库、医脉通网站、世界卫生组织网站、加拿大安大略注册护士协会网站、美国手术室注册护士协会网站、澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心数据库、Cochrane Library、Web of Science、EBSCO、Embase、CINAHL、Clinical Key、PubMed、万方数据知识服务平台、中国知网、中国生物医学文献数据库中关于ICH患者VTE预防和管理的文献。检索时间为建库至2024年4月。由两名经过培训的护理硕士研究生分别评估文献质量及根据文献纳入和排除标准独立筛选文献。由两名课题组成员负责整理证据,按主题提炼和整合关键信息。依据JBI证据预分级及证据推荐级别系统(2014版)评估证据级别。邀请1位循证护理专家、1位神经外科医生和5位护理专家,共同基于证据的实用性、适用性、临床重要性和效果确定推荐强度。结果 初步检索获得文献1 408篇,最终纳入文献17篇,包括指南6篇、专家共识4篇、证据总结3篇、临床决策2篇、系统评价2篇。文献质量评价结果:纳入的6篇指南中,4篇推荐级别为A级、2篇推荐级别为B级。纳入的4篇专家共识、2篇临床决策、3篇证据总结、2篇系统评价均评为高质量。最终形成了ICH患者VTE预防和管理的最佳证据,其包括风险评估、知情同意、基础预防、机械预防、药物预防、文书记录、出院教育7个方面共13条证据。结论 本研究总结的ICH患者VTE预防和管理的最佳证据包括风险评估、知情同意、基础预防、机械预防、药物预防、文书记录、出院教育7个方面共13条证据,可�Objective To summarize the best evidence for the prevention and management of venous thromboembolism(VTE)in patients with intracerebral hemorrhage(ICH)by reviewing relevant literature.Methods Based on the PIPOST model,an evidence-based question framework was established.Using the"6S"evidence model,a top-down computer system was used to search for literature on the prevention and management of VTE in patients with ICH in UpToDate,the Guideline International Network,the National Institute for Health and Clinical Excellence website,the Scottish Intercollegiate Guidelines Network,the National Guideline Clearinghouse,the Medlive website,the World Health Organization website,the Registered Nurses'Association of Ontario website,the Association of periOperative Registered Nurses website,the Joanna Briggs Institute(JBI)Evidence-Based Health Care Centre database,Cochrane Library,Web of Science,EBSCO,Embase,CINAHL,Clinical Key,PubMed,Wanfang Data,CNKI,and the Chinese Biomedical Literature Database.The search period ranged from the establishment of the databases to April 2024.The quality of the literature was independently evaluated and the literature was independently screened according to inclusion and exclusion criteria by two trained nursing master's students.Two members of the research group were responsible for collating the evidence,extracting and integrating the key information by theme.The evidence levels were evaluated in accordance with the JBI Pre-grading of Evidence and the Evidence Recommendation Level System(2014 version).One evidence-based nursing expert,one neurosurgeon,and five nursing experts were invited to jointly determine the recommendation strength based on the practicality,applicability,clinical importance,and effectiveness of the evidence.Results Initially,1408 articles were retrieved,and finally,17 articles were included,including 6 guidelines,4 expert consensuses,3 evidence summaries,2 clinical decisions,and 2 systematic reviews.The results of the literature quality evaluation were as follows:amon

关 键 词：脑出血 静脉血栓栓塞 预防 疾病管理 循证医学 

分 类 号：R743.34[医药卫生—神经病学与精神病学]