成人经口气管插管口腔护理的最佳证据总结

Summary of Best Evidence of Oral Care for Adults with Orotracheal Cannulas

目的 检索、评价并总结成人经口气管插管口腔护理的最佳证据,为临床实践提供参考。方法 遵循“6S”证据模型,系统检索国内外各数据库及指南网中关于成人经口气管插管口腔护理的所有证据,包括指南、系统评价、证据总结、最佳临床实践信息手册、专家共识、临床决策及高质量的原始研究。检索时限从建库至2022年8月5日。由2名研究人员独立对文献进行整体评价,并提取和汇总相关证据。结果 共纳入文献20篇,包括指南5篇、专家共识2篇、系统评价5篇、证据总结1篇、随机对照6篇、类实验研究1篇。根据相关内容共总结出成人经口气管插管口腔护理的25条证据,涉及口腔评估、口腔护理频次、口腔护理的方法和工具、口腔护理液、声门下吸引、管理和培训6个方面。结论 基于循证方法总结的关于经口气管插管口腔护理干预措施的最佳证据具有较好的科学性和可行性,可为重症患者口腔护理提供科学依据。

Objective To retrieve,evaluate and summarize the best evidence of oral care for adults with orotra⁃cheal cannulas,providing a reference for clinical practice.Methods All the evidence about oral care for adults with orotracheal cannulas were systematically retrieved from domestic and foreign databases and guide⁃lines websites following the"6S"evidence pyramid,covering guidelines,systematic review,evidence summary,information manuals of best clinical practice,expert consensuses,clinical decision⁃making and high⁃quality original studies.The retrieval time was from the establishment of the databases to August 5,2022.Two research⁃ers independently evaluated the selected articles,then extracted and summarized relevant evidence.Results A total of 20 articles were included,including 5 guidelines,2 expert consensuses,5 systematic reviews,1 evi⁃dence summary,6 randomized controlled studies and 1 quasi⁃experimental study.According to the related con⁃tents,25 pieces of evidence of oral care for adults with orotracheal cannulas were summarized,involving 6 as⁃pects:oral evaluation,oral care frequency,oral care methods and tools,oral care solution,subglottic secretion drainage,management and training.Conclusion The best evidence of oral care intervention measures sum⁃marized based on evidence⁃based methods is scientific and feasible,which can provide a scientific basis for oral care of critically ill patients.