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护理学报 ›› 2021, Vol. 28 ›› Issue (13): 46-51.doi: 10.16460/j.issn1008-9969.2021.13.046

• 循证护理 • 上一篇    下一篇

气管切开术后非机械通气患儿早期气道并发症预防的最佳证据总结

吕云霞a, 冯少娟a, 刘正伟b, 陈彦球a, 刘洁a, 黄洁莹a   

  1. 广州市妇女儿童医疗中心 a.外科八区; b.心血管科,广东 广州 510623
  • 收稿日期:2021-03-07 发布日期:2021-08-06
  • 通讯作者: 冯少娟（1974-）,女,广东广州人,本科学历,主管护师,护士长。E-mail:fsj@163.com
  • 作者简介:吕云霞（1987-）,女,河南周口人,硕士,主管护师。
  • 基金资助:
    广州市妇女儿童医疗中心护理内部科研基金（HLB-2020-15）

Best Evidence Summary for Prevention of Early Airway Complications in Children with Non-mechanical Ventilation after Tracheotomy

LV Yun-xiaa, FENG Shao-juana, LIU Zheng-weib, CHEN Yan-qiua, LIU Jiea, HUANG Jie-yinga   

  1. a. Dept. of General Surgery, Section VIII; b. Dept. of Cardiology, Guangzhou Women and Children's Medical Center,Guangzhou 510623, China
  • Received:2021-03-07 Published:2021-08-06

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摘要： 目的 检索并总结气管切开术后非机械通气患儿早期气道并发症预防的相关证据,为临床提供参考。 方法 按照PIPOST方法确定循证问题,依据证据的6S模型针对气管切开术后非机械通气患儿早期气道并发症的预防开展系统性检索,包括计算机决策、临床指南、专家共识、证据总结、最佳实践推荐、系统评价。检索时限为从建库至2020年4月1日。由2名研究者分别对文献质量进行评价和证据提取。 结果 共纳入文献11篇,其中指南1篇,证据总结2篇,推荐实践3篇,专家共识5篇;结合专业人员的判断,从患者管理、气管造瘘口的维护、固定带的更换、气道吸引、气道湿化、气管套管的更换6个方面进行证据总结,汇总了37条最佳证据。 结论 临床管理者应该重视对气管切开术后患儿的管理,制定儿科气管切开术后非机械通气期间早期气道护理的标准化方案,并对所有医护人员进行培训,规范气道护理操作,降低气道并发症的发生率。

关键词: 气管切开术, 儿童, 非机械通气, 气道护理, 并发症, 循证护理

Abstract: Objectives To search and summarize the best evidence regarding the prevention of early airway complications in children with non-mechanical ventilation after tracheostomy, and to provide reference for clinical staffs. Methods Evidence-based problems were identified with PIPOST method and systematic literature retrieval was carried out on the basis of 6S evidence model. The evidence regarding prevention of early airway complications in children with non-mechanical ventilation after tracheostomy was searched. It included computer decision system, guidelines, expert consensus, evidence summaries and best practice recommendations, and systematic reviews. Two researchers assessed the quality and extract evidence independently. The retrieval time was from the inception to April 1, 2020. Results A total of 11 articles were selected including 1 guideline, 2 evidence summary, 3 recommended practices and 5 expert consensus. According to professional judgment, 37 pieces of best evidences were summarized into 6 aspects: patient management, tracheostoma care, tape changing, tracheal suction, humidification and tracheostomy tubes changing. Conclusion Clinical managers should strengthen the management after tracheotomy in pediatric patients and develop a standardized care program to standardize nursing procedure, thus to reduce the incidence of airway complications.

Key words: tracheostomy, child, non-mechanical ventilation, airway nursing, complication, evidence-based nursing

中图分类号: 

  • R473.6
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