我国气管插管非计划性拔管文献的计量分析

Quantitative analysis on unplanned endotracheal extubation in China

目的通过系统分析与成人气管插管非计划性拔管相关的护理研究现状，了解国内预防非计划性拔管策略，明确存在问题，为今后的研究方向提供参考。方法采用文献计量分析方法，构建文献阅读数据库和评阅数据库，对1990年至2012年收录在中国生物医学期刊网（CBMdisc）、中国期刊全文数据库（CNKI）、万方数据库中符合纳入标准的335篇文献进行系统分析。结果文献数量呈逐年上升趋势，研究类型以病例系列报告（36．4％）、综述（16．7％）和经验介绍（14．6％）为主，研究内容涉及危险因素、预防策略、患者结局等。缺乏有效约束和患者烦躁是导致非计划性拔管事件发生的常见原因。结论近年来非计划性拔管备受临床关注，但是研究设计欠严谨，统计分析方法简单。亟需运用国际上不断涌现的科学证据，结合我国ICU文化及管理特点，运用循证的、科学的方法构建适宜于我国国情的预防气管插管非计划性拔管最佳实践手册。

Objective To investigate and analyze the current status of adult unplanned endotracheal extubation in China, understand the preventive strategies of unplanned endotracheal extubation, and supply reference for future research. Methods All publications concerning unplanned endotracheal extubation from CBMdisc, CNKI and Wangfang Database were analyzed by establishing the reference manage and ap- praisal databases with Noteexpress and SPSS software. Results The publications concerning unplanned endotracheal extubation grew steadily year by year. The major study type was case series report（36.4%）fol- lowed by review（16.7%） and experience introduction（14.6%）. Most literature focused on risk factors, pre- venting strategies, patients＂ outcomes and so on. Lacking of effective physical restraint and patients＂ anxious were the most common factors leading to unplanned endotracheal extubation. Conclusions Unplanned endotracheal extubation has got much attention from the clinical faculties recently. However, the domestic researchers focused on this topic lacked strict research design and efficient statistical methods. So it is im- perative to develop the best practice information sheet for preventing unplanned endotracheal extubation by evidenced-based and scientific method.