急诊成人脓毒症患者早期识别与护理的最佳证据总结

doi:10.3761/j.issn.2096-7446.2025.10.019

摘要/Abstract

摘要：

目的全面检索、筛选、评价并总结国内外关于急诊成人脓毒症患者识别与护理的最佳证据。方法计算机系统检索国内外网站及数据库中有关急诊成人脓毒症患者早期识别与护理的临床决策、推荐实践、证据总结、指南、系统评价、专家共识等。检索时限为2015年1月1日—2025年1月1日。结果最终纳入18篇文献，包括临床决策2篇、指南5篇、证据总结4篇、系统评价3篇及专家共识4篇。汇总了包括早期筛查与识别、集束化护理、血流动力学监测、呼吸支持、镇静镇痛、营养支持、血糖管理、团队协作与质量评价8个方面的34条证据。结论该研究总结了急诊成人脓毒症患者早期识别与护理的最佳证据，建议临床护理人员应结合国内的证据应用情境，有针对性地选择和转化证据，早期识别与及时抢救急诊成人脓毒症患者，以改善患者的临床结局。

关键词: 脓毒症, 脓毒性休克, 急诊, 循证护理学

Abstract:

Objective To comprehensively search，screen，evaluate，and summarize the best evidence of identification and nursing for emergency patients with sepsis at home and abroad. Methods The clinical decision，recommended practice，evidence summary，guidelines，systematic review，expert consensus on the early identification and nursing of emergency patients with sepsis were systematically searched in domestic and foreign databases. The search period was from January 1，2015 to January 1，2025. Results A total of 18 articles were included，including 2 clinical decisions，5 guidelines，4 evidence summaries，3 systematic reviews，and 4 expert consensuses. A total of 34 pieces of evidence from 8 aspects were summarized，including early screening and identification，cluster nursing，hemodynamic monitoring，respiratory support，sedation and analgesia，nutritional support，blood glucose management，teamwork and quality evaluation. Conclusion This study summarizes the best evidence for early identification and nursing of adult emergency patients with sepsis. It suggests that clinical nursing staff should combine the domestic evidence application situation to select and transform the evidence pertinently，implement the early identification and timely rescue of emergency patients with sepsis，to improve the clinical outcome of patients.

Key words: Sepsis, Septic Shock, Emergency, Evidence-Based Nursing

王玉川, 黄萍, 周田田, 陶俊杰, 陈蒙, 闫振龙, 何静静. 急诊成人脓毒症患者早期识别与护理的最佳证据总结[J]. 中华急危重症护理杂志, 2025, 6(10): 1253-1260.

WANG Yuchuan, HUANG Ping, ZHOU Tiantian, TAO Junjie, CHEN Meng, YAN Zhenlong, HE Jingjing. The best evidence summary of early identification and nursing care for emergency adult patients with sepsis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(10): 1253-1260.

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