局部枸橼酸抗凝在连续性肾脏替代治疗中的应用及管理的最佳证据总结

doi:10.16460/j.issn1008-9969.2024.04.048

摘要/Abstract

摘要： 目的总结基于局部枸橼酸抗凝的连续性肾脏替代治疗（Regional Citrate Anticoagulation-Continuous Renal Replacement Therapy, RCA-CRRT）的临床应用及管理的最佳证据,为临床工作提供证据支持。方法遵循JBI循证护理中心的临床证据实践应用系统的标准程序,检索相关指南网站、数据库以及专业领域学术网站中关于RCA-CRRT的临床实践指南、证据综合、专家共识及系统评价类文献,并对符合质量标准的文献进行证据提取及整合。结果共纳入18篇文献,包括证据总结3篇、临床决策1篇、临床指南2篇、专家共识2篇和系统评价10篇,最后从适用范围、方案制定、参数设置、过程监测、导管维护和质量控制6个方面形成了40条最佳证据。结论临床上进行局部枸橼酸抗凝的连续性肾脏替代治疗时,可参考本研究总结的6个方面中40条证据,制定个性化的治疗方案,操作过程中密切监测治疗及抗凝效果,为患者提供高质量护理。

关键词: 局部枸橼酸抗凝, 连续性肾脏替代治疗, 证据总结, 循证护理

Abstract: Objective To summarize the best evidence for the clinical application and management of regional citrate anticoagulation in continuous renal replacement therapy (RCA-CRRT). Methods Relevant guideline websites, databases and academic websites were systematically searched for the literature related to RCA-CRRT. Evidence extraction and integration from eligible literature was performed. Results Eighteen articles were included, including 3 evidence synthesis, 1 clinical decision, 2 clinical guidelines, 2 expert consensuses and 10 systematic reviews. Finally, 40 pieces of best evidence were formed from 6 aspects: scope of application, protocol development, parameter setting, process monitoring, catheter maintenance, and quality control. Conclusion To provide high-quality care for patients when conducting RCA-CRRT, personalized treatment plans and close monitoring of the treatment and coagulation can be developed by referring to the best evidence.

Key words: regional citrate anticoagulation, continuous renal replacement therapy, evidence summary, evidence-based nursing

中图分类号:

R473.5

杨建国, 何细飞, 鄢建军, 张梦, 杨纯子, 徐蓉, 王艳芳. 局部枸橼酸抗凝在连续性肾脏替代治疗中的应用及管理的最佳证据总结[J]. 护理学报, 2024, 31(4): 48-53.

YANG Jian-guo, HE Xi-fei, YAN Jian-jun, ZHANG Meng, YANG Chun-zi, XU Rong, WANG Yan-fang. Best evidence summary for application and management of regional citrate anticoagulation in continuous renal replacement therapy[J]. Journal of Nursing, 2024, 31(4): 48-53.

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