肺切除术后胸腔引流管管理的最佳证据总结

Summary of the best evidence for nursing management of thoracic drainage tube after pneumonectomy

目的检索肺切除术后胸腔引流管管理的相关证据,并总结最佳证据,为临床护士管理肺切除术后胸腔引流管提供循证依据.方法计算机检索UpToDate、Cochrane Library、Medline、PubMed等-数据库中关于肺切除术后胸腔引流管管理的所有证据,包括指南、推荐实践、证据总结、系统评价及相关的原始研究.检索时间为建库至2019年3月15日.结果共纳入文献13篇,从术后胸腔引流管的留置数量、观察、挤压及负压吸引、夹闭及断开的处理、拔管指征及拔管时机、管理人员6个方面汇总30条最佳证据.结论在肺切除术后胸腔引流管的管理中,护理人员应结合临床情境、患者意愿及应用证据的促进及阻碍因素选择最佳证据,以形成更科学、有循证依据的肺切除术后胸腔引流管管理方案.

Objective To retrieve the best evidence on management of thoracic drainage tube for patients after pneumonectomy and summarize the best available evidence for clinical nurses to provide evidence-based guidance for its management.Methods All evidence on management of thoracic drainage for patients after pneumonectomy was retrieved from databases and websites including UpToDate,Cochrane Library,Medline,PubMed.The retrieved evidence included guidelines,recommended practice,evidence summaries,systematic reviews and related original studies.The retrieval time is from the establishment of database to March 15,2019.Results A total of 13 pieces of evidence were included.Totally 30 pieces of best evidence were summarized from 6 aspects:the number of indwelling thoracic drainage tubes,observation,squeezing and negative pressure suction,treatment of clamping and disconnection,indication and timing of extubation,and management personnel.Conclusion Evidence users should select best evidence based on the clinical situation,patients’willingness,the facilitating factors and the obstacles to apply the evidence in order to form a more scientific and evidence-based practice plan for management of thoracic drainage tube after pneumonectomy.