心肌缺血患者连续ST段心电监测策略的最佳证据总结

doi:10.3761/j.issn.2096-7446.2026.02.018

Abstract

Abstract:

Objective To retrieve，evaluate and summarize the best evidence for continuous ST-segment monitoring in patients with myocardial ischemia，so as to provide an evidence-based basis for effectively identifying and warning of changes in medical condition. Methods We searched from 12 databases，9 guideline websites or association websites for literature on continuous ST-segment monitoring，up to December 31，2024，including guidelines，expert consensus，systematic reviews，evidence summaries and practice standards. Literature related was screened，and evaluated using the corresponding quality evaluation tools，and evidence was extracted and integrated from the final included literature. Results A total of 8 articles were selected，including 5 guidelines，2 practice standards and 1 evidence summary. Finally，8 themes were formed from 44 pieces of best evidence，including developing practical standards，continuing education and training，appropriate population and monitoring duration，posture and skin preparation，electrode placement，lead selection，alarm management，and documentation. Conclusion The best evidence for continuous ST-segment monitoring in myocardial ischemia patients summarized in this study is scientific and comprehensive. It is recommended that caregivers carefully select evidence based on clinical context，to fully utilize the monitoring effectiveness of electrocardiogram monitoring.

Key words: ST-Segment Monitoring, Cardiac Monitoring, Myocardial Ischemia, Lead Selection, Evidence-Based Nursing, Evidence Summary

WANG Jianjun, CHEN Shuhui, LIU Mengxin, MEI Fengling, WANG Li. Summary of the best evidence for continuous ST-segment monitoring in patients with myocardial ischemia[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 231-387.

Figures/Tables 2

References 39

[1]	黄永秋. 动态心电图诊断冠心病患者心肌缺血与心律失常的价值分析[J]. 中西医结合心血管病电子杂志, 2024, 12(5):94-97.
	Huang YQ. Value analysis of dynamic electrocardiogram in diagnosis of myocardial ischemia and arrhythmia in patients with coronary heart disease[J]. Cardiovasc Dis Electron J Integr Tradit Chin West Med, 2024, 12(5):94-97.
[2]	Steinberg JS, Varma N, Cygankiewicz I, et al. 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry[J]. Ann Noninvasive Electrocardiol,2017, 22(3):e12447. doi: 10.1111/anec.2017.22.issue-3
[3]	Pelter MM, Loranger DL, Kozik TM, et al. Among unstable angina and non-ST-elevation myocardial infarction patients,transient myocardial ischemia and early invasive treatment are predic-tors of major in-hospital complications[J]. J Cardiovasc Nurs, 2016, 31(4):E10-E19.
[4]	Thygesen K, Alpert JS, White HD, et al. Universal definition of myocardial infarction[J]. Circulation, 2007, 116(22):2634-2653. doi: 10.1161/CIRCULATIONAHA.107.187397 pmid: 17951284
[5]	张叶杭, 牛向东, 耿一鸣. 血清sST2、DcR3联合动态心电图对无症状性心肌缺血的诊断价值[J]. 天津医药, 2025, 53(4):420-424.
	Zhang YH, Niu XD, Geng YM. Diagnostic value of serum sST2 and DcR3 combined with dynamic electrocardiogram in silent myocardial ischemia[J]. Tianjin Med J, 2025, 53(4):420-424.
[6]	刘子杰, 李晓红, 姚和. 心电图平板运动试验对冠心病患者无症状性心肌缺血的诊断价值[J]. 现代电生理学杂志, 2021, 28(2):81-85.
	Liu ZJ, Li XH, Yao H. Diagnostic value of treadmill exercise test for silent myocardial ischemia in patients with coronary heart disease[J]. J Mod Electrophysiol, 2021, 28(2):81-85.
[7]	Sandau KE, Funk M, Auerbach A, et al. Update to practice stan-dards for electrocardiographic monitoring in hospital settings:a scientific statement from the American Heart Association[J]. Circulation, 2017, 136(19):e273-e344.
[8]	Drew BJ, Califf RM, Funk M, et al. Practice standards for elec-trocardiographic monitoring in hospital settings:an American Heart Association scientific statement from the Councils on Cardiovascular Nursing,Clinical Cardiology,and Cardiovascular Disease in the Young:endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical-Care Nurses[J]. Circulation, 2004, 110(17):2721-2746. doi: 10.1161/01.CIR.0000145144.56673.59
[9]	Johnson KL. AACN:procedure manual for progressive and cri-tical care[M]. 8.St.Louis, MO:Elsevier, 2024.
[10]	李婷, 胡慧玲, 吴雪. ICU多参数心电监护仪阈值设置证据总结[J]. 中华危重病急救医学, 2023, 35(6):643-650.
	Li T, Hu HL, Wu X. Summary of evidence for threshold set-ting of multi-parameter electrocardiograph monitor in inten-sive care unit[J]. Chin Crit Care Med, 2023, 35(6):643-650.
[11]	岳丽青, 李幸, 刘鹏, 等. 多参数监护仪临床警报管理实践指南(2020版)简版[J]. 中国护理管理, 2021, 21(5):758-765.
	Yue LQ, Li X, Liu P, et al. Practice recommendation for clinical alarm management of multi-parameter monitors in 2020(simplified version)[J]. Chin Nurs Manag, 2021, 21(5):758-765.
[12]	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017, 32(21):1991-1994.
	Zhu Z, Hu Y, Xing WJ, et al. The composition of different types of evidence based problems[J]. J Nurses Train, 2017, 32(21):1991-1994.
[13]	Alper BS, Brian Haynes R. EBHC pyramid 5.0 for accessing preappraised evidence and guidance[J]. Evid Based Med, 2016, 21(4):123-125. doi: 10.1136/ebmed-2016-110447 pmid: 27325531
[14]	Brouwers MC, Kerkvliet K, Spithoff K, et al. The AGREE Re-porting Checklist:a tool to improve reporting of clinical practice guidelines[J]. BMJ, 2016,352:i1152.
[15]	周英凤, 胡雁, 朱政, 等. JBI循证卫生保健中心文本证据的质量评价清单[J]. 护士进修杂志, 2024, 39(10):1075-1080.
	Zhou YF, Hu Y, Zhu Z, et al. Critical appraisal checklist for textual evidence developed by JBI Center of Evidence-Based Health Care[J]. J Nurses Train, 2024, 39(10):1075-1080.
[16]	胡雁, 周英凤. 循证护理:证据临床转化理论与实践[M]. 上海: 复旦大学出版社, 2021.
	Hu Y, Zhou YF. Evidence clinical implementation:theory and practice[M]. Shanghai: Fudan Press, 2021.
[17]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
	Wang CQ, Hu Y. JBI evidence pre-classification and evidence rank system(2014 Edition)[J]. J Nurses Train, 2015, 30(11):964-967.
[18]	Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guide-lines for the management of acute coronary syndromes[J]. Eur Heart J,2023, 44(38):3720-3826. doi: 10.1093/eurheartj/ehad191
[19]	Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation:The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC)[J]. Eur Heart J,2018, 39(2):119-177. doi: 10.1093/eurheartj/ehx393
[20]	American Association of Critical-Care Nurses. AACN practice alert:ensuring accurate ST-segment monitoring[J]. Critical Care Nurse, 2016, 36(6):e18-e25. doi: 10.4037/ccn2016935 pmid: 27908956
[21]	Sampson M. Continuous ECG monitoring in hospital:part 1,indications[J]. Br J Card Nurs, 2018, 13(2):80-85.
[22]	Sampson M. Continuous ECG monitoring in hospital:part 2,practical issues[J]. Br J Card Nurs, 2018, 13(3):128-134.
[23]	Porritt K, Moola S. Evidence summary. Continuous electrocar-diographic monitoring in hospitals:general principles inclu-ding lead selection and alarm management[J]. The JBI EBP Database,2022,JBI-ES-1291-2.
[24]	Fålun N, Oterhals K, Pettersen T, et al. Cardiovascular nurses’ adherence to practice standards in in-hospital telemetry moni-toring[J]. Nurs Crit Care, 2020, 25(1):37-44. doi: 10.1111/nicc.12425 pmid: 30969471
[25]	何春雷, 徐小群, 王祥娜, 等. 护理人员对参数监护仪临床警报管理的现况调查[J]. 护理学杂志, 2023, 38(12):60-62,71.
	He CL, Xu XQ, Wang XN, et al. Clinical nurses’ practices toward physiologic monitor alarms[J]. J Nurs Sci, 2023, 38(12):60-62,71.
[26]	Carolina B de S Giusti A, Estevam Cornélio M, Machado de Oliveira E, et al. Standard practices in cardiac monitoring:training needs of intensive care unit nurses[J]. BMC Nurs, 2024, 23(1):82. doi: 10.1186/s12912-024-01742-1 pmid: 38297281
[27]	Buluba SE, He JY, Li H. Practice and confidence in electro-cardiogram interpretation among ICU nurses:a cross-sectional study[J]. Intensive Crit Care Nurs, 2025, 86:103835. doi: 10.1016/j.iccn.2024.103835
[28]	Buluba SE, He JY, Li H. ICU nurses’ knowledge and attitude towards electrocardiogram interpretation in Fujian province,China:a cross-sectional study[J]. Front Med, 2023, 10:1260312. doi: 10.3389/fmed.2023.1260312
[29]	Chen YY, Kunst E, Nasrawi D, et al. Nurses’ competency in electrocardiogram interpretation in acute care settings:a syste-matic review[J]. J Adv Nurs, 2022, 78(5):1245-1266. doi: 10.1111/jan.v78.5
[30]	Jepsen S, Sendelbach S, Ruppel H. AACN practice alert:Managing alarms in acute care across the life span:electro-cardiography and pulse oximetry[J]. Crit Care Nurse, 2018, 38(2):e16-e20. doi: 10.4037/ccn2018468
[31]	Geffin R, Triska J, Najjar S, et al. Why do we keep missing left circumflex artery myocardial infarctions?[J]. J Electrocar-diol, 2024, 83:4-11.
[32]	Haeberlin A, Studer E, Niederhauser T, et al. Electrocardiogra-phic ST-segment monitoring during controlled occlusion of coronary arteries[J]. J Electrocardiol, 2014, 47(1):29-37. doi: 10.1016/j.jelectrocard.2013.10.003 pmid: 24238737
[33]	杭莺, 刘马超, 徐艳. 连续ST段监测在护理实践中应用与管理的研究进展[J]. 护士进修杂志, 2019, 34(3):247-252.
	Hang Y, Liu MC, Xu Y. Research progress on application and management of continuous ST segment monitoring in nursing practice[J]. J Nurses Train, 2019, 34(3):247-252.
[34]	范东, 张玉, 王玉萍, 等. ICU护士心电监护仪警报应答疲劳现状及影响因素分析[J]. 齐鲁护理杂志, 2024, 30(9):61-64.
	Fan D, Zhang Y, Wang YP, et al. Analysis of alarm response fatigue status and influencing factors of ICU nurses’ ECG monitor[J]. J Qilu Nurs, 2024, 30(9):61-64.
[35]	Paine CW, Goel VV, Ely E, et al. Systematic review of phy-siologic monitor alarm characteristics and pragmatic interven-tions to reduce alarm frequency[J]. J Hosp Med, 2016, 11(2):136-144. doi: 10.1002/jhm.v11.2
[36]	郭芝廷, 唐佳迎, 张玉萍, 等. ICU医疗设备警报管理策略及应用成效的范围综述[J]. 中华急危重症护理杂志, 2024, 5(12):1130-1137.
	Guo ZT, Tang JY, Zhang YP, et al. A scoping review of ICU medical equipment alarm management strategies and effec-tiveness[J]. Chin J Emerg Crit Care Nurs, 2024, 5(12):1130-1137.
[37]	Garcia T. 12-lead ECG:The Art of Interpretation[M]. 2nd ed. Burlington, MA: Jones and Bartlett, 2015.
[38]	Houghton A, Gray D. Making sense of the ECG:A hands-on guide[M]. 4th ed. BocaRaton, FL: CRC Press, 2014.
[39]	张奕, 陈香萍, 邵桑, 等. 床旁心电监护仪报警管理的最佳证据总结[J]. 中华护理杂志, 2021, 56(3):445-451. doi: 10.3761/j.issn.0254-1769.2021.03.023
	Zhang Y, Chen XP, Shao S, et al. Evidence summary for ma-nagement of bedside electrocardiogram monitor alarms[J]. Chin J Nurs, 2021, 56(3):445-451.

Summary of the best evidence for continuous ST-segment monitoring in patients with myocardial ischemia

RichHTML

PDF (PC)

Supplement

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 2

References 39

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	SUN Huihui, DING Jingping, ZHANG Yuxin, HAO Xiaochen, ZHANG Bingliang. Summary of the best evidence for prevention and management of alcohol relapse behavior in patients with alcoholic liver disease after liver transplantation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(3): 350-357.
[2]	DENG Meng, GAO Helei, WANG Wenchun, LI Xiaoqing, ZHANG Zonghao, YU Yun. Best evidence summary for infection prevention and management in patients with left ventricular assist device implantation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(3): 358-365.
[3]	HUANG Fangfang, JIANG Yunlong, LIU Shengnan, ZHOU Yan, HU Jun, WEI Jianhua. Summary of the best evidence on non-pharmacological pain management in the perioperative period for patients undergoing cardiac surgery [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(3): 365-372.
[4]	ZHANG Dan, YE Juan, WU Liya, ZHANG Mengyu, LIANG Jinjing, LING Mi. Summary of the best evidence for prevention and management of ventilator-associated pneumonia in preterm infants [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 54-60.
[5]	FENG Lu, LI Yan, JING Jie, NIE Xinyue, HU Huan, TANG Binzhi. Best evidence summary for family participatory non-pharmacological management of procedural pain in NICU neonates [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 61-69.
[6]	SONG Ping, HU Min, ZENG Jie. Evidence summary for assessment and nursing care for chemotherapy-induced peripheral neuropathy [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1124-1130.
[7]	XU Xin, WANG Zixin, WANG Wei, FENG Xiuqin. A scoping review of central venous pressure monitored via peripherally inserted central catheters [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1138-1143.
[8]	HAN Lin, JU Ping, WANG Xueting, YANG Lijuan, KONG Qingjie, XIAO Hong, MENG Lihong. Meta-integration of qualitative research on the experience of emergency medical staff caring for self-harm patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 1003-1009.
[9]	WANG Yijia, PAN Aihong, LIU Rui, CHEN Qian, WANG Chengchen. Risk factors for post-traumatic stress disorders in family members of intensive care unit patients：a meta-analysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 938-944.
[10]	JIANG Weilin, WANG Li, HUANG Zhenzhen, YAN Ran, YI Jia, ZHUANG Yiyu. Influencing factors of sleep disorders in post-ICU patients：a systematic review and meta-analysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 945-952.
[11]	WANG Dongxue, SUN Lijun, GONG Ying, WU Linjing, ZHENG Weiliang. Development of audit indicators and analysis of barriers for early enteral nutrition support in prone mechanical ventilation patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 805-811.
[12]	AN Xiao, JIANG Shumin. Risk prediction models for subsyndromal delirium in ICU patients：a systematic review [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 866-871.
[13]	ZHANG Yumei, WANG Hanmin, GUO Shuping, LANG Xiaoqing, WANG Lijuan, LI Li. Summary of the best evidence for skin care in adults with Stevens-Johnson syndrome and toxic epidermal necrolysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 872-878.
[14]	ZHOU Hongfang, YUE Weigang, WU Yuchen, HE Chengying, LAN Xuhong, WANG Hengyang, JIA Donghui, WANG Qian, ZHANG Zhigang. The application of decision aids for patients with life-support treatment in ICU：a scoping review [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 885-890.
[15]	XU Yanan, LIU Yahui, WANG Danruo, KANG Yubiao, YUAN Ling. A meta-synthesis of the qualitative studies of the influencing factors of palliative care implemented by ICU medical staff [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 737-743.