成人骨科全麻术后进水管理的最佳证据总结

Summary of the best evidence for postoperative water intake management in adult orthopedic general anesthesia

目的总结成人骨科全麻术后进水管理的最佳证据,为临床实践提供参考。方法计算机检索美国指南网(National Guideline Clearinghouse,NGC)、英国医学期刊(British Medical Journal,BMJ)、美国围麻醉期护士协会(American Society of PeriAnesthesia Nurses,ASPAN)、UpToDate临床决策系统、GeenMedical、Cochrane Library、PubMed、Medline、中国知网、万方数据库、医脉通、中华医学会骨科学分会、中国医疗保健国际交流促进会骨科学分会、促进术后恢复学会(Enhanced Recovery After Surgery Society,ERAS)和白求恩公益基金会骨科分会官网中关于成人骨科全麻术后进水的相关文献。文献质量评价由2名研究者独自进行证据采集、处理和整合,并对证据进行级别划分和推荐强度的判定。结果共纳入15篇文献,包括3篇指南、2篇证据总结、1篇系统评价、5篇专家共识、4篇随机对照试验。汇总出21条成人骨科全麻术后进水管理的最佳证据,共涉及5个方面,分别为评估方法、时机选择、评价、健康教育和质量控制。结论本研究总结了成人骨科全麻术后进水管理的最佳证据,为医护人员提供循证依据,医护人员应利用科学的方法管理全麻术后骨科患者,从而提高患者舒适度,提高护理精准度和护理质量。

Objective To summarize the best evidence of water intake management after adult orthopedic general anesthesia,and to provide references for clinical practice.Methods We systematically searched for the evidence on postoperative water intake management in adult orthopedic general anesthesia in National Guideline Clearinghouse(NGC),British Medical Journal(BMJ),American Society of PeriAnesthesia Nurses(ASPAN),UpToDate Clinical decision system,GeenMedical,Cochrane Library,PubMed,Medline,CNKI,Wanfang Database,Yi Maitong Guidelines Network,Chinese Orthopaedic Association,Orthopaedics Branch of China International Exchange and Promotive Association for Medical and Health Care,Enhanced Recovery After Surgery Society(ERAS)and Orthopaedic Committee of Bethune Charitable Foundation.The literature quality evaluation was carried out by two researchers alone to collect,process and integrate the evidence,classify the evidence,and determine the intensity of recommendation.Results A total of 15 articles were included,including 3 guidelines,2 evidence summaries,1 systematic review,5 expert consensus,and 4 randomized controlled trials.This study summarizes 21 pieces of the best evidence of water intake management after adult orthopedic general anesthesia,which involves 5 aspects,including evaluation method,timing selection,evaluation,health education,and quality control.Conclusion This study summarizes the best evidence of water intake management after adult orthopedic general anesthesia and provides an evidence-based basis for medical staff.Medical staff should use scientific methods to manage orthopedic patients after general anesthesia,so as to improve patients′comfort,improve nursing accuracy and nursing quality.