目的 总结预防成人ICU患者外周静脉损伤的最佳证据,为临床实践提供参考。方法 系统检索相关数据库或网站关于预防成人ICU患者外周静脉损伤的文献,包括临床决策、指南、专家共识、随机对照试验、系统评价,检索时限为2018年1月—2023年1月。由2名研究者独立评价文献质量,提取并汇总证据。结果 共纳入15篇文献,其中临床决策2篇、证据总结1篇、指南1篇、系统评价4篇、专家共识4篇、随机对照试验3篇。从预防外周静脉损伤的导管留置、预防外周静脉损伤的导管维护、预防静脉炎、预防药物外渗、预防导管堵塞、预防感染6个方面总结了22条证据。结论 该研究总结了预防成人ICU患者外周静脉损伤的最佳证据,为规范使用和管理外周静脉提供循证依据,建议应用证据指导临床操作,以提高外周静脉使用的安全性。
Objective To search the literature and use evidence-based method to evaluate and summarize evidence,providing a basis for the prevention of peripheral intravenous injury in ICU adult patients and a reference for clinical practice. Methods Systematic search was conducted in related websites and databases on all evidence about the peripheral intravenous injury management for ICU adult patients,including clinical decision-making,guidelines,consensus,randomized controlled trials and systematic reviews. The search time limit was from January,2018 to January,2023. Two researchers evaluated the quality of the literature,extracted and summarized the evidence independently. Results Totally 15 articles were involved,including two clinical decisions,one evidence summary,one guideline,four systematic reviews,four expert consensuses,and three randomized controlled trials. 22 pieces of best evidence were summarized from 6 aspects：catheter indwelling to prevent peripheral intravenous injury,catheter maintenance to prevent peripheral intravenous injury,peripheral phlebitis prevention,drug extravasation prevention,catheter obstructions prevention,and infection prevention. Conclusion This study summarizes the current best evidence for the prevention of peripheral intravenous injury in ICU adult patients and provides an evidence-based basis for the correct use and manage of peripheral vein. Evidence is recommended to guide clinical procedures and improve safety of peripheral vein use in ICU adult patients.
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