儿童外周静脉穿刺疼痛管理相关实践指南的质量评价和分析

Quality assessment of clinical practice guidelines regarding management of venipuncture pain in children

目的系统地检索并评价现有的儿童外周静脉穿刺疼痛管理相关实践指南的质量,为儿童外周静脉穿刺疼痛管理实践提供建议。方法在各类数据库和指南网站上检索2009年1月至2018年10月发表的指南,使用AGREEII工具对纳入的指南进行质量评价。结果评价纳入5篇临床实践指南,AGREEII6个领域平均得分前三位的领域依次为:范围和目的(92.24±3.44)%、参与人员(86.62±6.63)%、清晰性(82.94±7.23)%。按照疼痛评估、疼痛测量、疼痛管理和疼痛干预4个方面汇总出23条推荐意见。结论儿童外周静脉穿刺疼痛管理临床实践指南数量不多,指南制定的严谨性、应用性领域有待提高。我国尚无针对性的儿童外周静脉穿刺疼痛管理实践指南,可考虑将国外较为成熟的指南引入我国并进行跨文化调适,指导我国儿童外周静脉穿刺疼痛管理实践。

Objective To systematically retrieve and assess the quality of clinical practice guidelines(CPGs)regarding management of venipuncture pain in children,and to provide suggestions for clinical practice.Methods All CPGs pertaining to venipuncture in children issued between January 2009 and October 2018 were searched in electronic databases and related websites of guidelines,then the included CPGs were evaluated using the Chinese version of the Appraisal of Guidelines for Research and Evaluation(AGREE)II.Results We identified 5 eligible CPGs.The domain of scope and purpose in the AGREE II scored the highest(92.24±3.44)%,followed by stakeholder involvement(86.62±6.63)%and clarity of presentation(82.94±7.23)%.Twenty-three recommendations were summarized into the following categories:pain assessment,measurement,management and intervention.Conclusion The CPGs pertaining to management of venipuncture pain in pediatric patients is limited,and the domains of rigor of development and applicability need to be improved.There is no Chinese CPG regarding this topic,so we can introduce well-accepted CPGs and conduct cross-cultural adaptation,thus to guide evidence-based practice for management of venipuncture pain in pediatric patients.