儿童气道廓清技术临床应用及使用原则的最佳证据总结

doi:10.3761/j.issn.2096-7446.2025.03.018

摘要/Abstract

摘要：

目的检索并汇总儿童气道廓清技术临床应用及使用原则的最佳证据。方法系统检索国内外数据库和相关协会官方网站中的相关证据，包括临床决策、指南、系统评价、证据总结和专家共识等，检索时限为建库至2024年4月20日，由2名经过循证方法学系统培训的研究者对文献进行质量评价、提取、整合证据。结果纳入18篇文献，包括5篇临床决策、5篇指南、3篇系统评价、5篇专家共识。从操作要求、适应证、禁忌证、操作前评估、频率、方案选择、疗效评估、健康教育8个方面，汇总了21条儿童气道廓清技术临床应用的最佳证据，同时还汇总了8项儿童气道廓清技术（叩击和体位引流、自体引流、肺内叩击通气、呼气末正压、主动呼吸循环技术、机械辅助振荡排痰、机械吸-呼技术、运动）的25条使用原则。结论医护人员应结合患儿实际情况选择性应用最佳证据，规范进行儿童气道廓清技术。

关键词: 儿童, 气道廓清, 证据总结, 循证护理学

Abstract:

Objective To retrieve and summarize the best evidence on clinical application and principles of pediatric airway clearance techniques. Methods Systematic searches were conducted in various databases and association websites up to April 20，2024， including clinical decisions，guidlines，systematic reviews，evidence summary and expert consensus. Literature quality was assessed and evidence was extracted by two researcher who received systematic training of evidence-based methodology. Results 18 studies were included，including 5 clinical decisions，5 guidelines，3 systematic reviews，5 expert consensuses. 21 pieces of best evidence for clinical application of pediatric airway clearance techniques were summarized across eight aspects，including procedural requirements，indications，contraindications，pre-procedure assessment，frequency，selection of methods，efficacy evaluation，and health education. 25 application principles for 8 pediatric airway clearance techniques were also summarized，including percussion and postural drainage，autogenic drainage，intrapulmonary percussive ventilation，positive end-expiratory pressure，active cycle of breathing techniques，mechanical oscillatory devices，mechanical insufflation-exsufflation，and exercise. Conclusion Medical staff should apply best evidence based on the child’s condition to standardize airway clearance techniques.

Key words: Children, Airway Clearance, Evidence Summary, Evidence-Based Nursing

程环毓, 吕芳芳, 马欣雨, 祝筠. 儿童气道廓清技术临床应用及使用原则的最佳证据总结[J]. 中华急危重症护理杂志, 2025, 6(3): 358-364.

CHENG Huanyu, LÜ Fangfang, MA Xinyu, ZHU Yun. Summary of best evidence on clinical application and principles of airway clearance in children[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 358-364.

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