普萘洛尔治疗婴幼儿血管瘤临床疗效评价与应用护理方法最佳证据总结

Best evidence summary on the clinical efficacy evaluation and applied nursing methods of propranolol in the treatment of infantile hemangioma

目的:检索分析并总结普萘洛尔治疗婴幼儿血管瘤临床疗效评价与应用护理方法的相关证据,为医护人员普萘洛尔临床运用实践提供依据。方法:采取循证护理方法,针对婴幼儿血管瘤使用普萘洛尔治疗疗效与应用护理,检索NGC、NCBI、Europe PMC、NICE、Cochrane Library、Wiley、RNAO、中国知网(CNKI)、Nature、PubMed Central、BMJ最佳临床实践(Best Practice)、WHO官方网站、ENA等权威数据库或网站。采用AMASTAR量表评价,选取JCI制定的"调查研究或试验研究质量评价工具"以及其他对应文献质量评价工具进行文献质量评定与证据级别评价。结果:最终从8篇文献总结出22项证据,包括普萘洛尔临床用药有效性及安全性、适应证与给药前评估、正确给药不良反应防护、婴幼儿血管瘤疗后观察及记录、做好患儿家属心理护理与出院指导5个方面。结论:临床医护人员使用这些证据时,应合理评估自身医疗机构临床条件、医护人员认知、相关促进与阻碍因素、病人意愿与偏好,实施针对性证据选取,并持续更新确保使用最佳证据。

Objective:To retrieve,analyze and summarize the evidence of clinical efficacy evaluation and nursing methods of propranolol in the treatment of infantile hemangioma,so as to provide a basis for the clinical practice of propranolol for medical staff.Methods:Evidence-based nursing methods were adopted to treat infantile hemangioma with propranolol treatment efficacy and applied nursing.NGC,NCBI,Europe PMC,NICE,Cochrane Library,Wiley,RNAO,CNKI,Nature,PubMed Central,BMJ Best Practice,WHO official website,ENA and other authoritative databases or websites were search.The AMASTAR scale was used for evaluation,and the Investigation Research or Experimental Research Quality Evaluation Tool formulated by JCI and other corresponding literature quality evaluation tools are selected for literature quality evaluation and evidence level evaluation.Results:Finally,22 items of evidence were summarized from 8 literatures,including clinical efficacy and safety of propranolol,indications and pre-administration evaluation,correct administration of adverse reaction protection,observation and recording of infant hemangioma after treatment,psychological care and discharge guidance for family members of children in 5 aspects.Conclusions:When using these evidences,clinical medical staff should reasonably evaluate the clinical conditions of their own medical institutions,the cognition of medical staff,relevant promotion and hindrance factors,patients′wishes and preferences,implement targeted evidence selection,and continue to update to ensure the use of the best evidence.