预防围手术期患者低体温的最佳证据总结

Evidence summary for prevention of perioperative hypothermia in patients

目的遴选并获取国内外预防围手术期非计划性低体温的相关证据,并对最佳证据进行总结。方法系统检索PubMed、Up To Date、Cochrane Library、Joanna Briggs Institute(JBI)循证卫生保健中心数据库、美国医疗保健研究与质量局数据库、围手术注册护士协会指南库、护理及相关健康领域文献积累索引数据库、加拿大安大略护理学会网站、英国国家医疗保健优化研究所指南库、中国指南网、中国知网、万方数据库和中国生物医学文献数据库等数据库内关于预防围手术期非计划性低体温的所有证据,包括指南、系统评价、最佳实践信息册、证据总结、专家共识等。检索时限为建库至2018年08月29日。由2名研究员对文献质量进行独立评价,结合专业人士的判断,对符合标准的文献进行资料提取。结果共纳入13篇文献,其中指南2篇,专家共识3篇、系统评价6篇、最佳实践信息册1篇、证据总结1篇。最佳证据包括术前评估、体温监测技术、术前干预措施、术中干预措施、术后干预措施和质量管理,共30条。结论手术室护士应定期接受围手术期非计划性低体温相关知识培训,并使用科学的工具进行风险评估。证据应用人员需结合医院特点和临床环境,有针对性的选择最佳证据,以降低手术患者非计划性低体温发生率。

Objective To collect and summarize evidence for prevention of unplanned perioperative hypothermia. Methods We systematically search for evidence on prevention of unplanned perioperative hypothermia in PubMed,Up To Date,Cochrane Library,JBI,AHRQ,AORN,CINAHL,RNAO,NICE,CGC,CNKI,Wanfang,CBM and other data-bases,including guidelines,systematic reviews,best practices information sheet,evidence summary,expert consensus,etc. The retrieval period was from the inception of databases to August 29,2018. Two authors independently evaluated literature quality and extracted evidence. Results A total of 13 articles were included,including 2 guidelines,3 expert consensus,6 systematic reviews,1 best practice information sheet,and 1 evidence summary. The best evidence included preoperative assessment,temperature monitoring,preoperative interventions,intraoperative interventions,postoperative interventions and quality management. Conclusion Operating room nurses should regularly receive training on unplanned perioperative hypothermia,use scientific tools to assess the risks. Evidence users should select best evidence with consideration of hospital characteristics and clinical settings in order to reduce unplanned perioperative hypothermia.