成年人重症脑损伤患者颅内高压护理的最佳证据总结

Summary of the best evidence for intracranial hypertension care in adults with severe brain injury

目的总结成年人重症脑损伤患者颅内高压护理的最佳证据,为临床护理实践提供参考。方法采用循证方法学,在中国知网、万方、PubMed、Cochrane Library和Cinahl Plus等国内外数据库,以及相关指南网站和专业协会网站中,对建库至2022年8月有关成年人重症脑损伤患者颅内高压护理的中英文文献进行系统的检索。由2名研究人员独立进行证据筛查及文献质量评价,证据汇总后由项目团队进行总结和归纳。结果初步检索共获得文章6009篇,经筛选后最终纳入文献33篇,包括指南13篇,系统评价1篇,专家共识17篇,证据总结1篇,Meta分析1篇。共总结出33条最佳证据共8个维度,包括相关阈值、评估与监测、呼吸护理、循环护理、镇痛镇静护理、体温护理、营养护理及脑脊液引流护理。结论总结成年人重症脑损伤患者颅内高压护理的循证依据,为后续其临床护理策略的规范化构建提供了基础。

Objective To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury,and to provide reference for clinical nursing practice.Methods According to the evidence-based methodology,a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI,Wanfang,PubMed,Cochrane Library and Cinahl Plus and so on,as well as related guide websites and professional association websites from the establishment of database to August 2022.Two researchers independently evaluated literature quality and screened evidence,and then the project team summarized and concluded the evidence.Results A total of 6009 articles were obtained through preliminary search,and 33 articles were included after screening,including 13 guidelines,1 systematic review,17 expert consensus,1 evidence summary,and 1 meta-analysis.In total,33 pieces of best evidence were obtained from 8 dimensions,including intracranial pressure related threshold,assessment and monitoring,respiratory care,circulation care,analgesic and sedative care,temperature care,nutrition care and cerebrospinal fluid care.Conclusions This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury,which provides a basis for the standardized construction of clinical nursing strategies and empirical research.