成人主动脉夹层患者围手术期脊髓损伤评估与管理的最佳证据总结

doi:10.3761/j.issn.2096-7446.2024.08.016

摘要/Abstract

摘要： 目的汇总成人主动脉夹层患者围手术期脊髓损伤评估与管理的最佳证据。方法按照证据金字塔“6S”模型,系统检索指南库、专业学会及数据库中的指南、专家共识、系统评价及原始研究,检索时限为建库至2023年1月31日。由2名研究者分别对文献进行质量评价、提取和整合。结果共纳入20篇文献,其中指南6篇、专家共识6篇、系统评价4篇、原始研究4篇。从危险因素评估、脊髓监测、预防性管理、对截瘫的护理、其他5个方面共汇总了27条最佳证据。结论目前证据大多来自国外,应进一步转化为本土化证据,并开展高质量原始研究丰富证据,以指导临床实践。

关键词: 主动脉夹层, 脊髓损伤, 评估, 管理, 证据总结, 循证护理学

Abstract: Objective To summarize the best evidence on assessment and management of perioperative spinal cord injury in adult patients with aortic dissection. Methods We searched guidelines,expert consensuses,system reviews and original studies from relevant guidance databases,professional associations and databases according to evidence pyramid “6s” Model. The search limit was from database establishment to January 31,2023. Two researchers conducted quality evaluation,extraction,and integration of the literature. Results Twenty articles were included,including 6 guidelines,6 expert consensuses,4 systematic reviews,and 4 original studies. Twenty-seven items of evidence were summarized from five dimensions,including risks assessment,spinal cord monitoring,prevention management,nursing of paraplegia and others. Conclusion Most evidence is from foreign studies and need to be further transformed into localized evidence. High-quality original studies are needed to rich the evidence and guide best practice.

Key words: Aortic Dissection, Spinal Cord Injury, Assessment, Management, Evidence Summary, Evidence-Based Nursing

李策, 王旖旎, 王欢, 吴荣. 成人主动脉夹层患者围手术期脊髓损伤评估与管理的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(8): 756-763.

LI Ce, WANG Yini, WANG Huan, WU Rong. Evidence summary of assessment and management for perioperative spinal cord injury in adult patients with aortic dissection[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(8): 756-763.

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