基于ERAS理念的妇科日间手术围术期管理最佳证据总结

Summary of best evidence for perioperative management of gynecologicaldaytime surgery based on the ERAS concept

目的系统检索、提取、汇总和分析基于ERAS理念的妇科日间手术围术期管理的最佳证据。方法计算机检索BMJ Best Practice、Up-To-Date、Cochrane Library、美国国立实践指南库(AHRQ)、国际指南协作网(G-I-N)、加拿大医学实践指南库(CMA)、苏格兰校际指南网(SIGN)、新西兰指南研究组(NZGG)、英国国家临床优化研究所(NICE)、加拿大安大略注册护士协会(RANO)、美国妇科腔镜协会(AAGL)、加拿大妇产科医师协会(SOGC)、Ovid、CINAHL、Web-of-Science、EMbase、PubMed、CNKI、万方数据库等检索平台中关于日间手术围术期管理的所有信息,包括临床实践、证据总结、临床意见、专家共识、系统评价等,同时整合证据,检索时间为建库至2023年2月。结果最终纳入文献11篇,分别为指南3篇、临床决策2篇、专家共识6篇,总结归纳出5个维度29条证据,包括全面的术前宣教、术前评估及管理策略、术中管理策略、术后管理策略、出院宣教及术后随访。结论本研究总结出基于ERAS理念的妇科日间手术围术期管理的29条证据,为临床护理提供循证实践依据,提高临床护理质量。

Objective To systematically search,extract,summarize and analyze the best evidence for perioperative management in gynecological day surgery based on the ERAS concept.Methods.We conducted searches from BMJ Best Practice,Up-To-Date,Cochrane Library,AHRQ,G-I-N,CMA,SIGN,NZCG,NICE,RANO,AAGL,SOGC,Ovid,CINAHL,Web-of-Science,EMbase,PubMed,CNKI and Wanfang databases to gather all information about perioperative management of daytime surgery,include clinical practice,evidence summaries,clinical opinion,expert consensuses,systematic reviews,etc,at the same time,the evidence was integrated,and the retrieval time was from the published to February 2023.Results11 articles were ultimately included,comprising 3 guidelines,2 clinical decision-making articles and 6 expert consensus articles.29 pieces of evidence were extracted and categorized into 5 themes:comprehensive preoperative education,preoperative evaluation and management strategies,intraoperative management strategies,postoperative management strategies,discharge education and postoperative follow-up.Conclusions This study provides a summary of 29 pieces of evidence on perioperative management in gynecological daytime surgery based on the ERAS concept,offering an evidence-based foundation for clinical nursing practice and enhancing its quality.