ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (5): 546-553.doi: 10.3761/j.issn.2096-7446.2026.05.005

• 儿科重症护理风险识别与管理实践 • 上一篇    下一篇

儿科重症监护病房患儿外周动脉导管评估与置入的循证护理实践

周敏1(), 王林娟1,*(), 李贾贾1, 杨娜1, 王巧霞1, 付坤会1, 黄雀兰2, 孟令雨1   

  1. 1 深圳市儿童医院重症医学科 深圳市 518000
    2 深圳市儿童医院医学技能部 深圳市 518000
  • 收稿日期:2025-05-14 出版日期:2026-05-10 发布日期:2026-04-28
  • 通讯作者: *王林娟，E-mail：771473725@qq.com
  • 作者简介:周敏：女，硕士，主管护师，E-mail：810799982@qq.com
    第一联系人：

    周敏：研究的构思与设计、主持项目实施与质量控制、组织数据采集、参与数据分析与论文撰写；王林娟：参与循证干预方案制订、工作支持、现场组织、协助论文撰写；李贾贾、杨娜、王巧霞：临床资料收集、数据整理、干预方案培训与实施；付坤会、黄雀兰：提供项目技术支持与资料管理、参与研究过程协调与数据核查；孟令雨：协助临床实施与数据采集、参与部分护理文献整理与论文内容校对

  • 基金资助:
    深圳市医疗卫生三名工程(SZSM202211034)

Evidence-based nursing practice for evaluation and insertion of peripheral arterial catheters in children in pediatric intensive care unit

ZHOU Min1(), WANG Linjuan1,*(), LI Jiajia1, YANG Na1, WANG Qiaoxia1, FU Kunhui1, HUANG Quelan2, MENG Lingyu1   

  1. 1 Department of Critical Care Medicine， Shenzhen Children’s Hospital， Shenzhen 518000， China
    2 Department of Medical Skills， Shenzhen Children’s Hospital， Shenzhen 518000， China
  • Received:2025-05-14 Online:2026-05-10 Published:2026-04-28
  • Contact: *WANG Linjuan，E-mail：771473725@qq.com
  • Supported by:
    Sanming Project of Medicine in Shenzhen(SZSM202211034)

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摘要：

目的 总结并应用儿科重症监护病房患儿外周动脉导管置入的最佳证据。方法 遵循乔安娜布里格斯研究所循证护理模式，结合渥太华模型，将前期研究中的10条危重症患儿外周动脉导管置入与管理的最佳证据转化为12条审查指标，比较基线审查期和证据应用再审查期护士执行率、首次穿刺成功率及并发症发生率。结果 证据应用再审查期，外周动脉导管置入的12条临床审查指标执行率整体呈上升趋势（48.24%与80.22%，χ2=189.379，P<0.001）；评估及置入维度执行率明显提高（P<0.001），其中外周动脉导管适应证评估、凝血功能评估、侧支循环监测、置管资质、感染预防及疼痛管理7条指标显著增高（P<0.05）。证据应用再审查期，首次穿刺成功率显著提高（58.9%与82.2%，χ2=10.899，P=0.001）；穿刺并发症发生率明显降低（22.4%与4.2%，χ2=11.208，P<0.001）。结论 将危重症患儿外周动脉导管置入的最佳证据应用于临床，可规范护士行为，提高护士循证证据执行率，预防相关并发症发生。

关键词: 重症监护病房, 儿科, 动脉导管, 导管插入术, 外周, 循证护理学, 儿科护理学

Abstract:

Objective To synthesize and apply the best evidence of peripheral arterial catheter（PAC） placement in the pediatric intensive care unit（PICU）. Methods Utilizing the Joanna Briggs Institute（JBI） evidence-based nursing framework and the Ottawa Model of Research Use，ten pieces of best evidence were discerned and converted into twelve clinical audit criteria. A comparative analysis was performed the baseline phase and the post-implementation re-audit phase to evaluate nurses’ adherence to evidence，initial success rates of PAC insertion，and the occurrence of complications. Results During the post-implementation re-audit phase，total compliance with the 12 audit criteria markedly improved（48.24% vs. 80.22%，χ2=189.379，P<0.001）. Significant enhancements were noted in both the assessment and insertion domains（P<0.001），with seven critical indicators—evaluation of indications，coagulation status assessment，collateral circulation，operator qualifications，infection prevention，and pain management—demonstrating statistically significant increases（P<0.05）. The success rate of initial attempts dramatically increased（58.9% vs. 82.2%，χ2=10.899，P=0.001），while the occurrence of insertion-related problems greatly diminished（22.4% vs. 4.2%，χ2=11.208，P<0.001）. Conclusion The best evidence application of PAC insertion into nursing practice in the PICU can standardize nurses’ behavior，improve evidence adherence of nurses，and prevent procedure-related complications in critically ill pediatric patients.

Key words: Intensive Care Units, Pediatric, Arterial Catheters, Catheterization, Peripheral, Evidence-Based Nursing, Pediatric Nursing