主动脉夹层患者围手术期管理最佳证据总结

Best evidence summary on perioperative management of patients with aortic dissection

目的检索、评价和总结主动脉夹层患者围手术期管理的相关证据,为临床提供参考。方法运用循证护理方法,按照“6S”模型检索相关文献,包括临床决策、指南、证据总结、专家共识、系统评价等,检索时限为建库至2022年1月24日。由2名研究者对文献质量进行评价和资料提取。结果共纳入24篇文献。其中8篇临床决策,4篇指南,8篇专家共识,2篇系统评价,1篇队列研究和1篇病例对照研究。从危险因素评估、病情监测、生命体征管理、疼痛管理、生活方式管理、药物服用、转运、随访8个方面汇总了15条最佳证据。结论该研究总结的针对主动脉夹层患者围手术期管理的最佳证据具有一定的科学性与实用性,可为医护人员有针对性地开展证据应用提供循证依据,以更好地指导临床实践,保障患者安全。

Objective To retrieve,evaluate and summarize the best evidence of perioperative management for patients with aortic dissection.Methods According to the“6S”model,we used evidence-based nursing method to retrieve the relevant literature,including clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,etc.The retrieval time limit was from the database construction to January 24,2022.There were 2 researchers who evaluated the quality of the literature,and extracted recommendations and research conclusions from the included literature.Results Totally 24 articles were involved,including 8 clinical decisions,4 guidelines,8 expert consensuses,2 systematic reviews,1 cohort study and 1 case-control study.Finally,15 pieces of best evidence about risk factors assessment,illness monitoring,vital signs management,pain mangagement,lifestyle mangagement,drug taking,transport and follow-up were summarized.Conclusion The best evidence for perioperative management of patients with aortic dissection summarized in this study is scientific and practical to a certain extent,which can provide evidence-based bases for medical staff to carry out the targeted evidence application,so as to better guide clinical practice and ensure patient safety.