儿童烧伤创面操作性疼痛非药物管理的最佳证据总结

Summary of the best evidence on non-pharmacological management for procedural pain of burn wounds in children

目的总结儿童烧伤创面操作性疼痛非药物管理的最佳证据。方法采用文献计量学方法。系统检索UpToDate、BMJ Best Practice、Cochrane Library、PubMed、Embase、Web of Science、CINAHL、Registered Nurses′Association of Ontario、Scottish Intercollegiate Guidelines Network、New Zealand Guidelines Group、Joanna Briggs Institute Evidence-Based Practice Database、American Burn Association、中国知网、万方数据库、维普数据库、中国生物医学文献服务系统、医脉通、梅斯医学等数据库公开发表的关于儿童烧伤创面操作性疼痛非药物管理的所有证据,包括指南、临床决策、证据总结、推荐实践、专家共识、系统评价,检索时限为建库至2023年8月。筛选文献并评价文献质量,从中提取证据并进行评价,总结最佳证据。结果纳入文献15篇,包括指南3篇、临床决策3篇、证据总结3篇、系统评价6篇,从疼痛多维度评估与识别,非药物管理原则、方法及注意事项,社会干预,健康教育,建立多学科团队,换药操作技术方面总结出31条最佳证据。结论从8个方面总结出31条有关儿童烧伤创面操作性疼痛非药物管理的最佳证据,可为临床烧伤患儿创面换药实践提供决策依据。

Objective To summarize the best evidence on non-pharmacological management for procedural pain of burn wounds in children.Methods Bibliometrics method was used for analysis.Systematic searches were carried out to retrieve all the publicly published evidences about non-pharmacological management for procedural pain of burn wounds in children,including guidelines,clinical decision-making,evidence summary,recommended practices,expert consensus,systematic review.Foreign language databases included UpToDate,BMJ Best Practice,Cochrane Library,PubMed,Embase,Web of Science,CINAHL,Registered Nurses′Association of Ontario,Scottish Intercollegiate Guidelines Network,New Zealand Guidelines Group,Joanna Briggs Institute Evidence-Based Practice Database,American Burn Association.Chinese databases included China National Knowledge Infrastructure,Wanfang Database,VIP Database,China Biomedical Literature Service System,Medlive,and MedSci.The search period was from the establishment of the database to August 2023.Literature quality evaluation was carried out to extract and evaluate the evidence,and summarize the best evidence.Results A total of 15 articles were identified,including 3 guidelines,3 clinical decision-making,3 evidence summaries,and 6 systematic reviews.A total of 31 best evidence recommendations were summarized,covering the multidimensional assessment and identification of pain,principles,methods and precautions of non-pharmacological management,social interventions,health education,establishment of interdisciplinary teams,operation techniques of wound dressing change.Conclusion Totally 31 best evidence recommendations on non-pharmacological management for procedural pain of burn wounds in children from 8 aspects are summarized,which can provide decision-making basis for wound dressing change practice in children with burns.