摘要
目的:目前关于中心静脉置管相关性血栓预防的内容涉及范围广且尚未形成系统的循证方案。本研究对化学治疗(以下简称“化疗”)患者经外周中心静脉导管(peripherally inserted central catheter,PICC)维持期深静脉血栓预防的相关证据提取汇总,评价后形成最佳证据,为临床护理实践提供循证依据。方法:通过PIPOST(population,intervention,professional,outcome,setting,type of evidence)法构建临床循证问题。检索乔安娜布里格斯研究所(Joanna Briggs Institute、JBI)、UpToDate、CINAHL、Cochrane Library、中国知网、万方、维普、Embase、PubMed、Sinomed、医脉通、美国输液护士协会网站中关于PICC维持期化疗患者相关深静脉血栓的相关指南、系统评价、专家共识、随机对照试验、临床决策、证据总结。检索时限为建库至2023年10月。由研究人员对所纳入的文献进行质量评价、证据等级划分,提取最佳证据。结果:最终纳入13篇文献,包括临床决策1篇、指南2篇、证据总结2篇、系统评价3篇、专家共识1篇、随机对照试验4篇。从评估、置管前中后、物理预防、药物预防、健康教育5个方面总结出36条最佳证据。结论:本研究总结了PICC维持期化疗患者相关深静脉血栓预防的最佳证据。医务人员和决策者可以结合具体的情况选择证据,以形成完整科学的护理管理策略,提升护理质量。
Objective:Currently,the content related to the prevention of central venous catheter-related thrombus is extensive and has not yet formed a systematic evidence-based protocol.This study aims to summarize and evaluate the evidence related to the prevention of deep vein thrombosis during the maintenance phase of a peripherally inserted central catheter(PICC)in chemotherapy patients,to form the best evidence and provide an evidence-based basis for clinical nursing practice.Methods:A clinical evidence-based question was constructed using the PIPOST(population,intervention,professional,outcome,setting,type of evidence)method.Relevant guidelines,systematic reviews,expert consensus,randomized controlled trials,clinical decisions,and evidence summaries about deep vein thrombosis in chemotherapy patients during the PICC maintenance period were retrieved from sources including the Joanna Briggs Institute(JBI),UpToDate,CINAHL,Cochrane Library,CNKI,Wanfang,VIP,Embase,PubMed,Sinomed,Yimaitong,American Association of Infusion Nurses website.The search was conducted up to October 2023.Researchers conducted quality assessments and evidence grading of the included literature and extracted the best evidence.Results:A total of thirteen literatures were included in the study,consisting of 1 clinical decision,2 guidelines,2 evidence summaries,3 systematic reviews,1 expert consensus,and 4 randomized controlled trials.A total of 36 best evidence items were summarized in 5 aspects:evaluation,pre-,intra-,and post-catheterization,physical prevention,pharmacological prevention,and health education.Conclusion:This study summarizes the best evidence related to the prevention of deep vein thrombosis during the maintenance phase of PICC in chemotherapy patients.Healthcare providers and decision-makers can select evidence based on specific circumstances to form comprehensive and scientific nursing management strategies,thus improving the quality of care.
作者
白璐
谢仙萍
武文静
郭巧玲
闫巧云
BAI Lu;XIE Xianping;WU Wenjing;GUO Qiaoling;YAN Qiaoyun(School of Nursing,Shanxi University of Chinese Medicine,Jinzhong Shanxi 030619;Department of Nursing,Shanxi Bethune Hospital,Taiyuan 030032;Department of Critical Care Medicine,Shanxi Bethune Hospital,Taiyuan 030032,China)
出处
《临床与病理杂志》
CAS
2024年第2期286-294,共9页
Journal of Clinical and Pathological Research
关键词
经外周中心静脉导管维持期
深静脉血栓
最佳证据总结
peripherally inserted central catheter maintenance period
deep venous thrombosis
summary of best evidence
