非药物干预预防连续性肾脏替代治疗体外循环凝血的最佳证据总结

doi:10.3761/j.issn.2096-7446.2024.12.011

摘要/Abstract

摘要： 目的检索并获取预防连续性肾脏替代治疗体外循环凝血非药物抗凝干预的最佳证据。方法系统检索UpToDate、PubMed、Cochrane Library、中国知网、万方数据库等数据库中关于预防连续性肾脏替代治疗体外循环凝血非药物抗凝干预的证据,检索时限为建库至2023年7月31日。循证团队进行文献筛选、质量评价,并提取、汇总证据。结果共纳入16篇文献,其中指南4篇,系统评价6篇,专家共识3篇,专家意见3篇,共汇总出针对团队、血管通路、机器、护理操作、患者5个方面的非药物抗凝干预建议,共23条最佳证据。结论该研究总结了目前预防连续性肾脏替代治疗体外循环凝血非药物抗凝干预的最佳证据,为规范护士对重症患者实施连续性肾脏替代治疗护理行为提供循证依据,有利于进一步提高重症患者连续性肾脏替代治疗的充分性。

关键词: 连续性肾脏替代治疗, 体外循环, 血液凝固, 证据总结, 循证护理学

Abstract: Objective To search and obtain the best evidence for non-pharmacological anticoagulant intervention for preventing clotting of extracorporeal circuits during CRRT. Methods We searched databases （UpToDate,PubMed,Cochrane Library,CNKI,Wanfang database,etc） to collect relevant clinical evidences related to non-pharmacological anticoagulant intervention for preventing clotting of extracorporeal circuits during CRRT. The retrieval time was from the establishment of the database to July 31,2023. Two investigators independently screened the literature,evaluated the quality of the literatures,extracted and integrated the evidence. Results A total of 16 articles were included in this study,including 4 guidelines,6 systematic reviews,3 expert consensuses,and 3 expert opinions. A total of 23 best evidences were summarized from 5 aspects,including team factors,vascular access factors,machine factors,operation-related factors,and patient factors. Conclusion This study summarizes the best evidence of non-pharmacological anticoagulant intervention for preventing clotting of extracorporeal circuits during CRRT,and provides evidence-based basis for standardizing nurses‘ CRRT nursing behavior for critically ill patients,and further improves the sufficiency of CRRT for critically ill patients.

Key words: Continuous Renal Replacement Therapy, Extracorporeal Circulation, Blood Coagulation, Evidence Summary, Evidence-Based Nursing

谢佩佩, 傅培荣, 刘莺莺, 林听雨, 盛中华, 杜琛, 张智容. 非药物干预预防连续性肾脏替代治疗体外循环凝血的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(12): 1116-1122.

XIE Peipei, FU Peirong, LIU Yingying, LIN Tingyu, SHENG Zhonghua, DU Chen, ZHANG Zhirong. Summary of the best evidence for non-pharmacological anticoagulant interventions for preventing clotting of extracorporeal circuits during CRRT[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(12): 1116-1122.

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