慢性阻塞性肺疾病患者无创通气器械相关压力性损伤预防的最佳证据汇总  

Summary of the best evidence for prevention of pressure injuries related to non-invasive ventilation de⁃vices in patients with chronic obstructive pulmonary disease

作　　者：吴双 彭佳 江海强 黄延锦[1] 李佩怡 席荣古丽•哈力力 吴传芳 WU Shuang;PENG Jia;JIANG Haiqiang;HUANG Yanjin;LI Peiyi;HALILI Xirongguli;WU Chuanfang(School of Nursing,University of South China,Hengyang 421000,China;Department of Respiratory Medicine,Changsha Central Hospital Affiliated to University of South China,Changsha 410000,China;IBI Xiangya Evidence-based Practice and Innovation Center,Central South University,Changsha 410000,China)

机构地区：[1]南华大学护理学院,湖南衡阳421000 [2]南华大学附属长沙中心医院呼吸内科,湖南长沙410000 [3]中南大学IBI湘雅循证实践与创新中心,湖南长沙410000

出　　处：《老年医学研究》2025年第2期24-30,共7页Geriatrics Research

基　　金：基金资助项目(2022JJ40642,院—校合作循证护理实践中配套教育模式的构建及实证研究)。

摘　　要：目的系统检索并总结慢性阻塞性肺疾病(COPD)患者无创通气过程中器械相关压力性损伤预防的有效证据,为临床护理提供循证依据。方法依据“6S”证据金字塔模型,检索国内外数据库中关于COPD患者无创通气过程中器械相关压力性损伤预防及管理的相关文献,检索时间跨度为数据库建立至2024年4月30日。由2名研究者依据JBI循证卫生保健中心的评价标准和证据分级体系,对文献进行评价和证据等级评定。结果共纳入8篇文献,包括指南2篇、系统评价3篇、专家共识1篇、证据总结2篇。最终整理出涵盖患者风险评估、皮肤和组织评估、预防性皮肤护理、营养管理、呼吸机面罩选择与佩戴、支撑面/敷料、培训与教育7个方面28条最佳证据。结论本研究总结了COPD患者无创通气器械相关压力性损伤预防的最佳证据。医护人员可结合临床情境灵活实施,推动循证证据向临床实践的有效转化,降低COPD患者无创通气过程中发生器械压力性损伤概率。Objective To systematically retrieve and summarize effective evidence on the prevention of device-relat-ed pressure injuries(DRPIs)during non-invasive ventilation(NIV)in patients with chronic obstructive pulmonary disease(COPD),providing evidence-based guidance for clinical nursing.Methods Following the"6S"evidence pyramid mod-el,domestic and international databases for literature on the prevention and management of DRPIs during NIV in COPD pa-tients were searched,with a time span from the establishment of the databases to April 30,2024.The literature was evalu-ated and the level of evidence was assessed using the appraisal standards and evidence hierarchy system from the JBI Evi-dence-Based Health Care Center by 2 researchers.Results A total of 8 articles were included,comprising 2 guidelines,3 systematic review,1 expert consensus,and 2 evidence summaries.Ultimately,28 best evidence items were collated cov-ering seven aspects,including patient risk assessment,skin and tissue assessment,preventive skin care,nutrition manage-ment,ventilator mask selection and fitting,support surfaces/dressings,and training and education.Conclusion The best evidence summarized in this study for preventing DRPIs during NIV in COPD patients can be flexibly implemented by healthcare professionals based on clinical contexts,facilitating the effective translation of evidence-based findings into clin-ical practice and reducing the incidence of DRPIs during NIV in COPD patients.

关 键 词：慢性阻塞性肺疾病 无创通气 器械相关压力性损伤 证据总结 循证护理 

分 类 号：R563[医药卫生—呼吸系统]