脑卒中患者目标体温管理的最佳证据总结

Summary of best evidence for target temperature management in stroke patients

目的检索、评价和总结脑卒中患者目标体温管理的相关证据,并对最佳证据进行汇总。方法根据证据“6S”金字塔模型,自上而下检索BMJBest Practice、UpToDate、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、国际指南协作网、美国国立指南库、英国国家临床医学研究所指南、苏格兰学院间指南网、加拿大安大略注册护士协会、美国心脏协会/美国卒中协会、欧洲卒中组织网站、医脉通、CochraneLibrary、PubMed、Embase、Webof Science、中国知网、万方数据库、维普网、中国生物医学数据库中关于脑卒中患者目标体温管理的相关的临床实践指南、专家共识、证据总结、系统评价。检索时限为建库至2022年10月7日。由2名接受过循证护理培训的研究人员独立对文献质量进行评价、提取和整合,总结出最佳证据。结果共纳入文献12篇,其中指南3篇、系统评价4篇和专家共识5篇,从目标体温人群、目标体温的实施、并发症监测、营养支持及预后评估5个方面总结出24条最佳证据。结论本研究采用循证的方法系统总结脑卒中患者目标体温管理的最佳证据,可为临床医护人员对脑卒中患者进行体温管理提供最佳决策依据,进一步规范体温监测及管理,为今后相关领域的研究和实践提供科学依据。

Objective To retrieve,evaluate,and sum up the evidence on target temperature management in stroke patients,and summarize the best evidence.Methods Based on the"6S"pyramid model,clinical practice guidelines,expert consensus,evidence summary,and systematic review on target temperature management in stroke patients were searched from top to bottom in British Medical Journal Best Practice,UpToDate,Joanna Briggs Institute Evidence-Based Health Care Center,Guidelines International Network,Agency for Healthcare Research and Quality,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,Registered Nurses'Association of Ontario,American Heart Association,American Stroke Association,European Stroke Organization,Medlive,Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure,WanFang Data,VIP and China Biology Medicine Disc.The search period was from database establishment to October 7,2022.Two researchers received evidence-based nursing training independently evaluated the quality of the article,extracted,integrated,and summarized the best evidence.Results A total of 12 articles were included,including three clinical practice guidelines,four systematic reviews,and five expert consensuses.24 best pieces of evidence were summarized from five aspects,involving target temperature population,target temperature implementation,complication monitoring,nutritional support,and prognosis evaluation.Conclusions This study adopts an evidence-based approach to systematically summarize the best evidence for target temperature management in stroke patients,which can provide the best decision-making basis for clinical medical and nursing staff to manage temperature in stroke patients,further standardize temperature monitoring and management,and offer scientific basis for future research and practice.