摘要
目的 检索、评价、总结左心室辅助装置(left ventricular assist device,LVAD)植入患者并发症预防及管理的相关证据,为临床工作提供参考.方法 采用PIPOST模式确立循证问题,制订检索策略,根据"6S"模型,系统检索中英文数据库、指南网站、专业协会网站中的指南、临床决策、专家共识及建议、系统评价、原始研究等文献.检索时限为建库至2023年5月1日.由2名研究者独立进行文献质量评价及证据提取、汇总.结果 共纳入18篇文献,其中临床决策1篇、专家共识10篇、指南3篇、队列研究4篇.最终总结出包含LVAD植入患者循环系统监测及管理、设备相关监测及管理、切口管理及感染监测、消化系统监测及管理、血栓形成预防及管理、神经系统监测及管理6个主题,共29条最佳证据.结论 该研究详细总结了LVAD植入患者并发症预防及管理的最佳证据,具备一定的科学性与实用性,可为医护人员进行LVAD植入患者术后并发症预防及管理提供循证依据.
Abstract
Objective To search,evaluate and summarize the evidence on postoperative complication prevention and management of patients with left ventricular assist device(LVAD)implantation,and to provide reference for clinical work.Methods The PIPOST model was used to establish evidence-based problems,and the search strategy was formulated to search Chinese and English databases,guide websites,professional association websites for the guidelines,clinical decisions,expert consensuses,systematic reviews,and original studies according to the"6S"model.The date of the search was from inception of the database to May 1,2023.Two researchers independently conducted literature quality evaluation,evidence extraction,and summarization.Results A total of 18 articles were included,including 1 clinical decision-making,10 expert consensuses,3 guidelines,and 4 cohort studies.Finally,29 items of best evidence were summarized in 6 themes,including circulatory system monitoring and management,device-related monitoring and management,wound management and infection monitoring,digestive system monitoring and management,thrombosis prevention and management,neural system monitoring and management of LVAD patients.Conclusion This study summarized the best evidence in detail for postoperative complication prevention and management of LVAD implanted patients,which is scientific and practical,and can provide evidence-based basis for medical staff to carry out postoperative complication prevention and management of LVAD patients.
维普
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