摘要
目的 检索、总结、评价并整合血液透析患者中心静脉导管功能不良预防及处理的最佳证据.方法 系统检索UpToDate、BMJ Best Practice、Cochrane Library、美国指南网、国际指南协作网、美国国家肾脏基金会、PubMed、中国知网等数据库中有关血液透析患者中心静脉导管功能不良预防的相关文献,包括指南、临床决策、证据总结、系统评价、专家共识.检索时限为2013年1月1日—2023年3月1日.由2名研究者独立评价文献质量,对纳人文献进行质量评价后提取证据.结果 共纳人文献15篇,其中指南3篇,临床决策3篇,专家共识5篇,系统评价2篇,证据总结1篇,政府文件1篇.最终形成人员培训与管理、评估与监测、导管置入、导管维护、药物预防、导管功能不良处理、健康教育7个主题和32条最佳证据.结论 本研究总结了血液透析患者中心静脉导管功能不良预防及处理的最佳证据,医护人员可以结合临床情境及患者意愿选择并应用该循证依据,进而降低导管功能不良发生率.
Abstract
Objective To retrieve,summarize,evaluate and integrate the best evidence for the prevention and management of center venous catheter dysfunction in hemodialysis patients.Methods The relevant literature on prevention of center venous catheter dysfunction in hemodialysis patients was systematically searched in UpToDate,BMJ Best Practice,Cochrane Library,National Guideline Clearinghouse,Guidelines International Network,National Kidney Foundation,PubMed,CNKI and other databases,including guidelines,clinical decision-making,evidence summary,systematic evaluation and expert consensus.The search period was from January 1st,2013 to March 1st,2023.Two researchers independently evaluated the quality of the literature,evaluated the quality of the included literature and extracted evidence.Results A total of 15 articles were included,including three guidelines,three clinical decision-making,five expert consensus,two systematic evaluations,one evidence summary and one government document.Ultimately,seven themes and 32 best evidence were formed,including personnel training and management,evaluation and monitoring,catheter insertion,catheter maintenance,drug prevention,catheter dysfunction management and health education.Conclusions This study summarizes the best evidence for the prevention and management of center venous catheter dysfunction in hemodialysis patients.Medical staff can choose and apply this evidence-based basis based on clinical situations and patient preferences,thereby reducing the incidence of catheter dysfunction.
基金项目
中华医学会杂志社护理学科研究课题(2021-2022)(CMAPH-NRD2021059)
NETL
NSTL
维普
万方数据