肠造口患者底盘渗漏预防与管理的最佳证据总结  

Summary of best evidence for the prevention and management of chassis leakage in enterostomy patients

作　　者：余志勇 朱小妹[2] 韦迪[2] 刘华云[2] 龚晓玲 熊鸣琴 YU Zhiyong;ZHU Xiaomei;WEI Di;LIU Huayun;GONG Xiaoling;XIONG Mingqin(The First Hospital of Changsha,Changsha 410005,China;Hunan Cancer Hospital,Changsha 410013,China;University of South China,Hengyang 421001,China)

机构地区：[1]长沙市第一医院,湖南省长沙市410005 [2]湖南省肿瘤医院,湖南省长沙市410013 [3]南华大学护理学院,湖南省衡阳市421001

出　　处：《护理实践与研究》2025年第3期406-413,共8页Nursing Practice and Research

基　　金：湖南省科学技术厅临床医疗技术创新引导项目(编号:2021SK51113);长沙市卫生健康委员会科研立项课题(编号:KJ-B2023103)。

摘　　要：目的检索、筛选、总结并分析国内外肠造口患者底盘渗漏预防与管理的相关证据并形成最佳证据总结,为临床护理人员预防和管理肠造口患者底盘渗漏提供循证依据,以降低患者底盘渗漏发生率,提高患者生活质量。方法遵循“6S”证据模型,系统检索BMJ Best Practice、Up To Date、JBI、WOCN、WCET、RNAO、美国指南网、the Cochrane Library、PubMed、Web of Science、Embase、医脉通、中国生物医学、中国知网、中国万方和中国研究型医院数据库中和肠造口患者底盘渗漏预防与管理有关的高级别证据,包括指南、临床决策、立场声明、专家共识、团体标准和证据总结。检索时限为建库至2023年9月,由两位研究人员对纳入文献进行质量评价,并提取相关资料信息,对最终纳入的文献进行翻译、证据总结和归纳。结果共纳入14篇文献,包括5篇指南、1篇临床决策、5篇专家共识、1篇立场声明、2篇证据总结。最终形成20条最佳证据,包括识别与判断、危险因素、术前定位、造口相关评估、渗漏管理、造口产品选用、健康教育与延续性护理7个方面。结论本文总结的肠造口患者底盘渗漏预防和管理最佳证据达到了全面、客观、科学的要求,能够为临床工作的顺利开展提供循证依据。护理人员应根据科室临床环境选择并应用最佳证据,以科学的方法预防和管理肠造口患者底盘渗漏,降低肠造口周围皮肤并发症的发生率,提高患者生活质量。Objective To retrieve,screen,summarize,and analyze the relevant evidence on the prevention and management of chassis leakage in enterostomy patients at home and abroad,and to form a best evidence summary.This aims to provide evidence-based guidance for clinical nursing staffto prevent and manage chassis leakage in enterostomy patients,thereby reducing the incidence of chassis leakage and improving the quality of life of patients.Methods Following the"6S"evidence model,high-level evidence related to the prevention and management of chassis leakage in ostomy patients was systematically retrieved from the BMJ Best Practice,Up To Date,JBI,WOCN,WCET,RNAO,USA Guidelines Network,the Cochrane Library,PubMed,Web of Science,Embase,Yimaitong,China Biology Medicine,CNKI,China Wanfang,and Chinese Research Hospital databases,including guidelines,clinical decision-making,position statements,expert consensus,group standards,and evidence summaries.The retrieval period was from the establishment of the database to September 2023.Two researchers evaluated the quality of the included studies and extracted relevant data.The final included studies were then translated,summarized,and synthesized.Results A total of 14 studies were included,consisting of 5 guidelines,1 clinical decision-making,5 expert consensus articles,1 position statement,and 2 evidence summaries.Ultimately,20 pieces of best evidence were formed,covering 7 aspects:identification and assessment,risk factors,preoperative localization,stoma-related assessment,leakage management,selection of stoma products,and health education and continuity of care.Conclusion The best evidence for the prevention and management of chassis leakage in enterostomy patients summarized in this article meets the requirements of comprehensiveness,objectivity,and science,providing an evidence-based basis for the smooth implementation of clinical practice.Nursing staffshould select and apply the best evidence based on the clinical environment of the department,using scientific methods to prevent a

关 键 词：肠造口 造口底盘 预防 管理 证据总结 

分 类 号：R473.6[医药卫生—护理学]