重症患者暴露性角膜损伤预防与管理的最佳证据总结

Summary of the best evidence for prevention and management of exposure corneal injury in severe patients

目的检索、提取、评价并整合重症患者暴露性角膜损伤预防与管理的相关证据,以期为临床实践提供参考。方法依据证据资源的"6S"金字塔模型,自上而下系统检索数据库、相关学会网站中关于重症患者暴露性角膜损伤预防与管理的证据,包括指南、专家共识、证据总结、系统评价等。检索时限为建库至2021年10月31日。由2名研究人员独立对文献质量进行评价,对符合质量标准的文献进行证据提取,并采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)证据预分级及证据推荐级别系统(2014版)对证据进行分级。结果共纳入15篇文献,其中指南2篇,证据总结2篇,系统评价6篇,随机对照试验5篇;共总结出42条关于重症患者暴露性角膜损伤预防与管理的最佳证据,包括评估、日常管理、风险管理、药物管理和程序管理5个方面。结论本研究总结了重症患者暴露性角膜损伤预防与管理的最佳证据,临床医护人员在对其进行临床转化时,应充分考虑患者实际情况,有针对性地选择证据,以降低重症患者眼部并发症的发生率。

Objective To retrieve,extract,evaluate and integrate relevant evidence on the prevention and management of exposure corneal injury in critically ill patients,so as to provide a reference for clinical practice.Methods Based on the"6S"pyramid model of evidence resources,the database and relevant society websites were systematically searched from top to bottom for evidence on the prevention and management of exposure corneal injury in critically ill patients,including guidelines,expert consensus,evidence summaries,and systematic reviews.The retrieval time limit was from the establishment of the database to October 31,2021.Two researchers independently assessed the quality of the article,extracted evidence from the article that met the quality standards,and adopted the Joanna Briggs Institute(JBI)evidence pre-grading and evidence recommendation system(2014 edition)to grade the evidence.Results A total of 15 articles were included,including 2 guidelines,2 evidence summaries,6 systematic reviews,and 5 randomized controlled trials.A total of 42 pieces of the best evidence on the prevention and management of exposure corneal injury in critically ill patients were summarized,including five aspects,namely,assessment,daily management,risk management,drug management and procedure management.Conclusions This study summarizes the best evidence for the prevention and management of exposure corneal injury in critically ill patients.When medical and nursing staff carry out clinical transformation,they should fully consider the actual situation of patients and select evidence in a targeted manner to reduce the incidence of ocular complications in critically ill patients.