心肌缺血患者连续ST段心电监测策略的最佳证据总结

doi:10.3761/j.issn.2096-7446.2026.02.018

摘要/Abstract

摘要：

目的检索、评价及总结心肌缺血患者连续ST段心电监测策略的最佳证据，为有效识别及预警病情变化提供循证依据。方法系统检索国内外12个数据库、9个指南网和协会网站关于连续ST段监测的相关证据，检索时限自建库起至2024年12月31日，文献类型包括指南、专家共识、证据总结、系统评价和实践标准。筛选符合主题的文献，选择相应的方法学评价工具进行质量评价，并对最终纳入文献进行证据提取和汇总。结果共纳入8篇文献，包括5篇指南、2篇实践标准、1篇证据总结。包含制订实践规范、教育培训、适宜人群及监测时长、体位及皮肤准备、电极放置位置、首优导联选择、报警管理、监测记录8个主题，共44条证据内容。结论该研究总结的心肌缺血患者ST段监测的最佳证据科学、全面，建议医护人员结合临床情境，审慎选择应用证据，以充分发挥心电监测的监测效能。

关键词: ST段监测, 心电监测, 心肌缺血, 导联选择, 循证护理学, 证据总结

Abstract:

Objective To retrieve，evaluate and summarize the best evidence for continuous ST-segment monitoring in patients with myocardial ischemia，so as to provide an evidence-based basis for effectively identifying and warning of changes in medical condition. Methods We searched from 12 databases，9 guideline websites or association websites for literature on continuous ST-segment monitoring，up to December 31，2024，including guidelines，expert consensus，systematic reviews，evidence summaries and practice standards. Literature related was screened，and evaluated using the corresponding quality evaluation tools，and evidence was extracted and integrated from the final included literature. Results A total of 8 articles were selected，including 5 guidelines，2 practice standards and 1 evidence summary. Finally，8 themes were formed from 44 pieces of best evidence，including developing practical standards，continuing education and training，appropriate population and monitoring duration，posture and skin preparation，electrode placement，lead selection，alarm management，and documentation. Conclusion The best evidence for continuous ST-segment monitoring in myocardial ischemia patients summarized in this study is scientific and comprehensive. It is recommended that caregivers carefully select evidence based on clinical context，to fully utilize the monitoring effectiveness of electrocardiogram monitoring.

Key words: ST-Segment Monitoring, Cardiac Monitoring, Myocardial Ischemia, Lead Selection, Evidence-Based Nursing, Evidence Summary

王建均, 陈蜀惠, 刘梦馨, 梅凤灵, 王黎. 心肌缺血患者连续ST段心电监测策略的最佳证据总结[J]. 中华急危重症护理杂志, 2026, 7(2): 231-387.

WANG Jianjun, CHEN Shuhui, LIU Mengxin, MEI Fengling, WANG Li. Summary of the best evidence for continuous ST-segment monitoring in patients with myocardial ischemia[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 231-387.

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