颅脑肿瘤患者术后恶心呕吐预防管理的最佳证据总结

Summary of best evidence for prevention and management of postoperative nausea and vomiting in patients with intracranial tumors

目的总结颅脑肿瘤患者术后恶心呕吐(postoperative nausea and vomiting,PONV)预防管理的最佳证据,为颅脑肿瘤患者的临床护理实践提供参考。方法根据循证护理的方法明确问题,并根据“6S”证据模型,检索有关颅脑肿瘤患者PONV的国内外证据,包括临床决策、指南、共识、证据总结等文献,由2名完成循证护理培训的研究员独立评价纳入文献,并对符合标准的文献进行证据提取。结果共纳入文献13篇,其中指南2篇,系统评价研究8篇,综述1篇,专家共识2篇。提炼出颅脑肿瘤患者PONV预防管理的最佳证据5个方面(危险因素、评估方式、干预管理、药物治疗和非药物治疗)、共20条。结论通过识别患者PONV的危险因素,评估患者风险等级,针对不同等级给予相对应干预措施,可为临床护理提供循证依据,帮助医护人员更好做出临床决策。

Objective To summarize the best evidence for prevention and management of postoperative nausea and vomiting(PONV)in patients with intracranial tumors to provide reference for clinical nursing practice of patients with intracranial tumors.Methods Based on the principles of evidence-based nursing,the research question was defined.According to the 6S evidence model,the domestic and international evidences related to PONV in intracranial tumor patients were retrieved,including clinical decisions,guidelines,consensus statements,evidence summaries and other relevant literatures.Two researchers who completed the training of evidence-based nursing independently evaluated the included literature,and the evidence was extracted from the literature that met the criteria.Results A total of 13 pieces of evidence were included,comprionsing 2 those on guidelines,8 on systematic review,1 on review,and 2 on expert consensus.The best evidence for the prevention and management of PONV in patients with intracranial tumors was summarized in 5 aspects(risk factors,assessment methods,interventional management,pharmacological treatments,and non-pharmacological treatments),totaling 20 items.Conclusions By identifying the risk factors of PONV in patients,assessing their risk level,and implementing corresponding intervention measures for different levels,evidence-based clinical nursing is provided to help medical staff make better clinical decisions.