择期开颅手术患者术后肺部并发症预防与管理最佳证据总结

Prevention and Management of Postoperative Pulmonary Complications in Patients Undergoing Elective Craniotomy:Best Evidence Summary

目的 评价和总结择期开颅手术患者术后肺部并发症(postoperative pulmonary complications, PPCs)预防与管理相关证据,为临床医护人员开展PPCs预防与管理提供循证依据。方法 计算机检索决策系统、专业协会网站、指南网站及相关数据库网站中关于择期开颅手术患者PPCs预防与管理的证据,包括指南、专家共识、临床决策和系统评价等,检索时间为建库至2021年12月,补充检索时间2022年7月。结果 共纳入15篇文献,其中专家共识5篇、指南3篇、临床决策2篇、系统评价5篇。提炼包括PPCs的评估与诊断、术前健康宣教、术前口腔护理、术前肺康复等13个方面的23条证据。结论 择期开颅手术患者PPCs预防与管理的最佳证据具有科学性和全面性,对临床护理人员规范术后患者PPCs的预防与管理有指导意义。

Objective To evaluate and summarize the evidence related to prevention and management of postoperative pulmonary complications(PPCs)in patients undergoing elective craniotomy,and to provide an evidence-based reference for prevention and management of PPCs in patients undergoing craniotomy.Methods The decision-making systems,professional association websites,guidelines websites and relevant database were searched for the guidelines,expert consensus,clinical decision-making and systematic reviews with the evidence on the prevention and management of PPCs in patients undergoing elective craniotomy.The retrieval time is from inceptions to December 2021,and the supplementary retrieval time is July 2022.Results A total of 15 pieces of literature were included,with 5 expert consensus,3 guidelines,2 clinical decisions and 5 systematic reviews.A total of 23 pieces of evidence in 13 categories were extracted,including the evaluation and diagnosis of PPCs,preoperative health education,preoperative oral care,and preoperative pulmonary rehabilitation.Conclusions The best evidence of prevention and management of PPCs in patients undergoing elective craniotomy summarized in this study is scientific and comprehensive,which is of guiding significance for clinical nursing staff to standardize the prevention and management of PPCs in patients after surgery.