缺血性脑卒中患者并发肺部感染预防和护理的最佳证据总结

Best evidence summary for prevention and nursing of ischemic stroke patients complicated with pulmonary infection

目的检索国内外关于缺血性脑卒中患者并发肺部感染预防及护理的最佳证据,并对证据进行评价和汇总,为临床护士提供科学的评估预防及护理计划的参考依据。方法依照6S[SEIRI(整理)、SEITON(整顿)、SEISO(清扫)、SEIKETSU(清洁)、SHITSUKE(素养)、SAFETY(安全)]循证逻辑顺序自上而下原则系统性地检索国内外文献,检索文献类型有最佳证据、指南、专家共识、临床实践、系统评价,检索时间为建库至2022年5月。由2名专业研究人员进行文献筛选,并进行质量评价和证据提取。结果共纳入12篇文献,其中指南2篇,系统评价5篇,专家共识1篇,证据总结3篇,临床决策1篇。总结的证据包括缺血性脑卒中并发肺部感染的危险因素评估、早期识别及预防、用药护理、饮食护理、加强呼吸道护理、体位调节、加强功能锻炼、口腔护理8个方面的30个推荐意见。结论缺血性脑卒中并发肺部感染的预防及护理具有一定实际性的参考意义,有助于提高临床护理质量。

Objective To search the best evidence about the prevention and nursing of pulmonary infection in patients with ischemic stroke at home and abroad,and evaluate and summarize the evidence,so as to provide scientific reference for clinical nurses to evaluate the prevention and nursing plan.Methods According to the principle of 6S[SEIRI(sorting out),SEITON(rectifying),SEISO(cleaning),SEIKETSU(sweeping),SHITSUKE(literacy)and SAFETY(safety)],the domestic and foreign literatures were systematically searched.The types of literatures searched were the best evidence,guidelines,expert consensus,clinical practice and systematic evaluation,and the retrieval time was from the establishment of the database to May 2022.Literature screening,quality evaluation and evidence extraction were conducted by two professional researchers.Results A total of 12 articles were included,including 2 guidelines,5 systematic reviews,1 expert consensus,3 evidence summaries and 1 clinical decision.The summarized evidence includes 30 recommendations from eight aspects:risk factor assessment,early identification and prevention,medication care,diet care,strengthening respiratory care,posture adjustment,strengthening functional exercise and oral care.Conclusion The prevention and nursing of ischemic stroke complicated with pulmonary infection has certain practical reference significance,which is helpful to improve the quality of clinical nursing.