院前创伤救治中正确管理与使用止血带的最佳证据总结  

Summary of best evidence for proper management and use of tourniquets in prehospital trauma care

作　　者：史梅 胡小花[1] 杨芳[1] SHI Mei;HU Xiaohua;YANG Fang

机构地区：[1]保山市人民医院护理部,云南省678000

出　　处：《中华急危重症护理杂志》2025年第4期441-447,共7页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：目的检索、评价和总结院前创伤救治中正确管理与使用止血带的相关证据,为院前救治实践提供参考和循证依据。方法检索中英文数据库、指南网站及专业学会网站,检索时限为2015年1月至2023年12月,文献类型包括临床决策、指南、系统评价、随机对照试验或类实验研究等。由2名研究者分别对文献进行质量评价及证据提取。结果共纳入文献16篇,其中临床决策1篇、指南1篇、系统评价4篇、专家共识3篇、随机对照试验3篇、类实验研究4篇。汇总了止血带使用适应证、禁忌证、出血程度的快速评估、止血带的选择、止血带绑扎部位及方法、止血带有效的标准及压力设置、时间设置、动态评估、明确标注、移除止血带、监测和重新评估、记录12个方面共22条证据。结论院前创伤救治中正确管理与使用止血带的证据总结具有科学性和实用性,可为院前创伤救治实践提供循证依据,为相应急救知识普及和培训提供参考。Objective To search,evaluate and summarize the relevant evidence of the application of tourniquet in pre-hospital trauma treatment,and provide reference and evidence-based basis for pre-hospital treatment practice.Methods Chinese and English databases,guideline websites and professional association websites were searched.The retrieval period was from January 2015 to December 2023,and the literature types included clinical decision support,guidelines,systematic reviews,randomized controlled trials or quasi-experimental studies,and so on.Two researchers respectively evaluated the quality of the literature and extracted the evidence.Results A total of 16 literatures were included,including a clinical decision,a guideline and 3 expert consensuses,4 systematic reviews,3 randomized controlled trials and 4 quasi-experimental studies.Twenty-two pieces of evidence were summarized from 12 aspects,including indications for tourniquet use,contraindications for tourniquet use,rapid assessment of bleeding severity,selection of tourniquet,location and method of dressing,effective criteria and pressure settings of tourniquets,time settings,dynamic evaluation,clear marking,removal,monitoring and re-evaluation of tourniquet,and recording.Conclusion The evidence summary of tourniquet application in pre-hospital trauma treatment is scientific and practical,which can provide evidence for pre-hospital trauma treatment practice,provide reference for popularization and training of first aid knowledge.

关 键 词：止血带 院前急救 创伤护理 循证护理学 证据总结 

分 类 号：R473.6[医药卫生—护理学]