以质量求发展,以服务铸品牌

护理学报 ›› 2023, Vol. 30 ›› Issue (16): 51-56.doi: 10.16460/j.issn1008-9969.2023.16.051

• 循证护理 • 上一篇    下一篇

间歇充气加压装置预防围术期深静脉血栓形成的最佳证据总结

龚雪1,2, 宋慧娟1, 廖少娜1,2, 杨晨1,2, 黄文嫣1,2   

  1. 1.南方医科大学南方医院 护理部,广东 广州 510515;
    2.南方医科大学 护理学院,广东 广州 510515
  • 收稿日期:2023-02-21 出版日期:2023-08-25 发布日期:2023-09-08
  • 通讯作者: 宋慧娟(1970-),女,江西高安人,硕士,主任护师,护理部副主任,硕士研究生导师。E-mail:13189097211@163.com
  • 作者简介:龚雪(1999-),女,江西萍乡人,本科学历,硕士研究生在读。
  • 基金资助:
    2022年度南方医院护理创优-循证护理项目(2022EBNc001)

Best evidence summary for intermittent pneumatic compression device in prevention of perioperative deep venous thrombosis

GONG Xue1,2, SONG Hui-juan1, LIAO Shao-na1,2, YANG Chen1,2, HUANG Wen-yan1,2   

  1. 1. Dept. of Nursing Administration, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
    2. School of Nursing, Southern Medical University, Guangzhou 510515, China
  • Received:2023-02-21 Online:2023-08-25 Published:2023-09-08

摘要: 目的 检索并整合间歇充气加压装置预防围术期深静脉血栓形成的相关证据,为临床实践提供参考。方法 根据“6S”证据模型,系统检索国内外中英文数据库及指南网站,检索时限为建库至2022年11月16日。由2名研究者独立对符合纳入标准的文献进行质量评价、证据提取和整合。结果 共纳入22篇文献,包括临床决策2篇、指南6篇、证据总结3篇、专家共识6篇和系统评价5篇。从风险评估与筛查、应用时机、设备选择与维护、实施策略、教育与培训5个方面汇总了23条最佳证据。结论 总结了间歇充气加压装置预防围术期深静脉血栓形成的最佳证据,可为临床实践提供参考,医护人员应结合患者个体因素和临床实际情境,审慎选择和应用证据。

关键词: 间歇充气加压装置, 围术期, 深静脉血栓形成, 证据总结

Abstract: Objective To retrieve and integrate the evidence of intermittent pneumatic compression device in the prevention of perioperative deep venous thrombosis and to provide reference for clinical practice. Methods According to the "6S" evidence model, the databases and guideline websites were systematically searched, then the quality of the eligible literature was evaluated by two researchers independently. The retrieval period was from the inception of the databases to November 16 2022. Results Twenty-two articles were collected, including 2 clinical decisions, 6 guidelines, 3 evidence summaries, 6 expert consensus and 5 systematic reviews. Twenty-three pieces of best evidence were summarized from 5 aspects of risk assessment and screening, timing of application, equipment selection and maintenance, implementation strategy, and education and training. Conclusion This study summarizes the best evidence of intermittent pneumatic compression device in the prevention of perioperative deep venous thrombosis, which provides reference for clinical practice. Medical staff should carefully select and apply evidence based on individual factors of the patients and clinical situations.

Key words: intermittent pneumatic compression device, perioperative period, deep venous thrombosis, evidence summary

中图分类号: 

  • R473.6
[1] Bartlett MA, Mauck KF, Stephenson CR, et al.Perioperative venous thromboembolism prophylaxis[J]. Mayo Clin Proc, 2020,95(12):2775-2798.DOI:10.1016/j.mayocp.2020.06.015.
[2] 钟伟权, 卞一啸, 吴朝键, 等. 间歇性充气加压治疗下肢慢性静脉功能不全的现状与研究进展[J]. 中国医学物理学杂志, 2022,39(10):1298-1302. DOI:10.3969/j.issn.1005-202X.2022.10.020.
[3] Urbankova J, Quiroz R, Kucher N, et al.Intermittent pneumatic compression and deep vein thrombosis prevention. A Meta-analysis in postoperative patients[J].Thromb Haemost, 2005,94(6):1181-1185. DOI: 10.1160/TH05-04-0222.
[4] 马娜, 张成欢, 曹青刚, 等. 骨科深静脉血栓形成物理预防实施现状调查[J]. 护理学杂志, 2019,34(1):27-31. DOI: 10.3870/j.issn.1001-4152.2019.01.027.
[5] Craigie S, Tsui JF, Agarwal A, et al.Adherence to mechanical thromboprophylaxis after surgery: a systematic review and Meta-analysis[J]. Thromb Res, 2015,136(4):723-726. DOI: 10.1016/j.thromres.2015.06.023.
[6] 张亚, 包倪荣, 刘云, 等. 间歇充气加压装置预防深静脉血栓形成依从性的研究进展[J]. 护理学杂志, 2017,32(18):106-110. DOI: 10.3870/j.issn.1001-4152.2017.18.106.
[7] 朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017,32(21):1991-1994. DOI: 10.16821/j.cnki.hsjx.2017.21.025.
[8] Dicenso A, Bayley L, Haynes RB.Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009,12(4):99-101. DOI: 10.1136/ebn.12.4.99-b.
[9] AGREE Next Steps Consortium. The AGREE II Instrument[EB/OL].(2017-11-30)[2022-11-28].https://www.agreetrust.org/wp-content/uploads/2017/12/AGREE-II-Users-Manual-and-23-item-Instrument-2009-Update-2017.pdf.
[10] 胡雁, 郝玉芳. 循证护理学[M]. 北京: 人民卫生出版社, 2018.
[11] 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015,30(11):964-967. DOI: 10.16821/j.cnki.hsjx.2015.11.002.
[12] Douketis JD, Mithoowani S. Prevention of venous thromboembolic disease in adult nonorthopedic surgical patients[EB/OL].(2022-11-04)[2022-11-16]. https://www.uptodate.cn/contents/prevention-of-venous-thromboembolic-disease-in-adult-nonorthopedic-surgical-patients?search=Prevention%20of%20venous%20thromboembolic%20disease%20in%20adult%20nonorthopedic%20surgical%20patients&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.
[13] Pai M, Douketis JD. 成人骨科术后静脉血栓栓塞的预防[EB/OL].(2022-10-27)[2022-11-16]. https://www.uptodate.cn/contents/zh-Hans/prevention-of-venous-thromboembolism-in-adults-undergoing-hip-fracture-repair-or-hip-or-knee-replacement?search=%E6%88%90%E4%BA%BA% E9%AA%A8%E7%A7%91%E6%9C%AF%E5%90%8E%E9%9D%99%E8%84%89%E8%A1%80%E6%A0%93%E6%A0%93%E5%A1%9E%E7%9A%84%E9%A2%84%E9%98%B2&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.
[14] Valdez, F. Evidence Summary. Abdominal surgery: mechanical prophylaxis for venous thromboembolism[EB/OL].(2022-09-09)[2022-11-16].https://ovidsp.dc2.ovid.com/ovid-b/ovidweb.cgi?&S=APEKFPOOGJEBNAMLJPMJJHIHIHAIAA00&Link+Set=S.sh.21%7c1%7csl_190.
[15] Atieno, M. Evidence Summary. Orthopedic surgery: mechanical prophylaxis for venous thromboembolism[EB/OL].(2021-09-06)[2022-11-16].https://ovidsp.dc2.ovid.com/ovid-b/ovidweb.cgi?&S=APEKFPOOGJEBNAMLJPMJJHIHIHAIAA00&Link+Set=S.sh.41%7c1%7csl_190.
[16] Porritt, K, Swe, K. Evidence Summary. Cardiothoracic and vascular surgery: mechanical prophylaxis for venous thromboembolism (VTE)[EB/OL].(2022-02-15)[2022-11-16]. https://ovidsp.dc2.ovid.com/ovidb/ovidweb.cgi?&S=APEKFPOOGJEBNAMLJPMJJHIHIHAIAA00&Link+Set=S.sh.45%7c1%7csl_190.
[17] Liew NC, Alemany GV, Angchaisuksiri P, et al.Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism[J]. Int Angiol, 2017,36(1):1-20. DOI: 10.23736/S0392-9590.16.03765-2.
[18] The National Institute for Health and Care Excellence. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism[EB/OL].(2019-08-13)[2022-11-16].https://www.nice.org.uk/guidance/ng89.
[19] Guideline summary: prevention of venous thromboembolism[J]. AORN J, 2018,107(6):750-754. DOI: 10.1002/aorn.12147.
[20] Anderson DR, Morgano GP, Bennett C, et al.American Society of Hematology 2019 guidelines for management of venous thromboembolism:prevention of venous thromboembolism in surgical hospitalized patients[J].Blood Adv, 2019,3(23):3898-3944. DOI:10.1182/bloodadvances.2019000975.
[21] Afshari A, Ageno W, Ahmed A, et al.European Guidelines on perioperative venous thromboembolism prophylaxis: Executive summary[J]. Eur J Anaesthesiol, 2018,35(2):77-83. DOI: 10.1097/EJA.0000000000000729.
[22] 专家委员会中国血栓性疾病防治指南. 中国血栓性疾病防治指南[J]. 中华医学杂志, 2018,98(36):2861-2888. DOI: 10.3760/cma.j.issn.0376-2491.2018.36.002.
[23] 上海市肺栓塞和深静脉血栓防治联盟, 国际血管联盟中国分部护理专业委员会, 上海市护理学会外科护理专业委员会. 间歇充气加压用于静脉血栓栓塞症预防的中国专家共识[J]. 中华普通外科杂志, 2022,37(7):549-553. DOI: 10.3760/cma.j.cn113855-20220316-00161.
[24] 马玉芬, 徐园, 王晓杰, 等. 普通外科患者静脉血栓栓塞症风险评估与预防护理专家共识[J].中华护理杂志, 2022,57(4):444-449.DOI:10.3761/j.issn.0254-1769.2022.04.009.
[25] 植艳茹, 李海燕, 陆清声. 住院患者静脉血栓栓塞症预防护理与管理专家共识[J]. 解放军护理杂志, 2021,38(6):17-21. DOI: 10.3969/j.issn.1008-9993.2021.06.005.
[26] 中国健康促进基金会血栓与血管专项基金专家委员会. 静脉血栓栓塞症机械预防中国专家共识[J]. 中华医学杂志, 2020,100(7):484-492. DOI: 10.3760/cma.j.issn.0376-2491.2020.07.002.
[27] 北京护理学会手术室专业委员会, 中日友好医院. 手术室静脉血栓栓塞症预防与护理专家共识[J]. 中华现代护理杂志,2022,28(20):2661-2669.DOI:10.3760/cma.j.cn115682-20220411-01731.
[28] Amarase C, Tanavalee A, Larbpaiboonpong V, et al.Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 2. Mechanical venous thromboembolism prophylaxis[J]. Knee Surg Relat Res, 2021,33(1).DOI:10.1186/s43019-021-00101-7.
[29] Kakkos S, Kirkilesis G, Caprini JA, et al.Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism[J]. Cochrane Database Syst Rev, 2022,1(1):D5258. DOI: 10.1002/14651858.CD005258.pub4.
[30] Zhao JM, He ML, Xiao ZM, et al. Different types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients after total hip replacement[J]. Cochrane Database Syst Rev,2014(12):CD009543. DOI:10.1002/14651858.CD009543.pub3.
[31] Pavon JM, Adam SS, Razouki ZA, et al.Effectiveness of intermittent pneumatic compression devices for venous thromboembolism prophylaxis in high-risk surgical patients: a systematic review[J]. J Arthroplasty, 2016,31(2):524-532. DOI: 10.1016/j.arth.2015.09.043.
[32] Greenall R, Davis RE.Intermittent pneumatic compression for venous thromboembolism prevention: a systematic review on factors affecting adherence[J]. BMJ Open, 2020,10(9). DOI: 10.1136/bmjopen-2020-037036.
[33] 崔露萍, 吴荷玉, 褚婕. 术中使用间歇充气加压装置对术后静脉血栓影响的Meta分析[J]. 护理研究, 2020,34(17):3034-3040. DOI: 10.12102/j.issn.1009-6493.2020.17.006.
[34] 潘姝丞, 卞丽芳, 骆华芳, 等. 护士深静脉血栓形成风险知识与预防实践现状及影响因素分析[J].护理学报, 2023,30(8):7-12. DOI: 10.16460/j.issn1008-9969.2023.08.007.
[35] 喻静, 刘晓艳. 间歇充气加压开始使用时间对骨科大手术患者血流动力学和下肢深静脉血栓的影响[J]. 中国实用护理杂志, 2021,37(32):2526-2531.DOI:10.3760/cma.j.cn211501-20200828-03710.
[36] 施若霖, 张丽青, 孙捷豪, 等. 间歇充气加压装置不同使用模式对预防直肠癌腹腔镜术中患者静脉血栓的效果[J]. 中华护理杂志, 2022,57(6):695-702. DOI:10.3761/j.issn.0254-1769.2022.06.008.
[37] Mosti G, Partsch H.A wearable compression device to normalise calf muscle pump function in chronic venous insufficiency for each postural position[J]. Eur J Vasc Endovasc Surg, 2019,57(5):702-707.DOI:10.1016/j.ejvs.2018.12.017.
[38] Phillips JJ, Gordon SJ.Intermittent pneumatic compression dosage for adults and children with lymphedema: a systematic review[J]. Lymphat Res Biol, 2019,17(1):2-18. DOI: 10.1089/lrb.2018.0034.
[39] 刘雪晶, 李晓允, 任环宇, 等. 间歇充气加压联合低分子肝素预防下肢深静脉血栓形成的临床研究[J].护理研究, 2011,25(3):241-242. DOI: 10.3969/j.issn.1009-6493.2011.03.034.
[40] 周琪, 丁俊琴, 张秀果, 等. 间歇性充气加压装置预防深静脉血栓的研究进展[J]. 护士进修杂志, 2023,38(1):34-38. DOI: 10.16821/j.cnki.hsjx.2023.01.007.
[41] 杨晶慧, 甘秀妮, 李钱玲, 等. 髋关节置换术后间歇充气加压装置最佳使用时间的随机对照研究[J]. 护理研究, 2020,34(5):778-783. DOI:10.12102/j.issn.1009-6493.2020.05.013.
[42] 范志英, 焦文仓, 王亚红, 等. 间歇充气加压装置不同使用时长对预防腰椎融合术中患者静脉血栓的效果评价[J]. 中华护理杂志, 2022,57(4):449-454. DOI: 10.3761/j.issn.0254-1769.2022.04.010.
[43] 于欢, 张岚, 孔亚男, 等. 肺癌术后患者使用间歇充气加压装置预防静脉血栓栓塞症依从性的质性研究[J].锦州医科大学学报, 2023,44(1):70-74. DOI: 10.13847/j.cnki.lnmu.2023.01.002.
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