喉切除气管切开非机械通气住院患者气道湿化管理的证据总结

Evidence summary for the airway humidification management of the inpatient with laryngectomy and tracheotomy but nonmechanical ventilation

目的检索、评价和总结与喉切除气管切开非机械通气住院患者气道湿化管理相关的证据,为临床护理提供依据。方法根据研究目的提出循证问题;按照证据资源金字塔模型自上而下进行计算机检索,检索时间为建库至2018年12月,文献类型包括指南、证据总结、最佳实践、推荐实践、系统评价;根据文献类型选择合适的文献质量评价工具;使用JBI系统相关工具确定证据等级及推荐级别。结果共纳入13篇文献,包括指南1篇、证据总结2篇、最佳实践1篇、系统评价9篇,总结出13条证据,归纳为湿化的评估、方式、液体和操作等4方面。结论本研究所得证据具有一定的科学性和实用性,但一方面需进行临床情境分析并有针对性地使用证据;另一方面,现有证据存在欠缺和质量不高,故需以科学合理的方法创造高质量证据并持续更新。

Objective To retrieve,appraise and summarize the evidence for the airway humidification management of the inpatient with laryngectomy and tracheotomy but nonmechanical ventilation and to provide references for the clinical nursing.Methods The evidence question was raised based on the study objective.The evidence was retrieved from some databases according to the evidence pyramid model during inception to December,2018.The literature types included clinical practice guideline,evidence summary,best practice information sheet,recommended practice and systematic review.The quality of the literature were evaluated by the suitable evaluated tool based on their types.The level and recommedation grade of the evidence were appraised by the suitable tools of JBI.Results Thirteen studies were recruited,including one clinical practice guideline,two evidence summaries,one best practice information sheet and nine systematic reviews.Totally thirteen items of best evidence were summarized and generalized to four categories including assessment,method,liquid and operation of airway humidification.Conclusion The evidences of the studies are scientific and practical,but on the one hand,it is recommended that when applying the evidences in clinic,it is necessary to assess the clinical situation and chose the proper evidence.And on the other hand,there are lacking of some evidences of airway humidification and the level of some evidences is low.So it needs to create more high level evidences.