基于证据总结的脑脊液外引流管相关颅内感染的预防策略

Prevention strategy for intracranial infection related to external cerebrospinal fluid drainage tube based on evidence summary

目的检索并提取预防脑脊液外引流相关颅内感染的最佳证据,为降低脑脊液外引流颅内感染的发生率提供循证依据。方法根据PIPOST确定循证护理问题,自上而下依次检索关于脑脊液外引流管相关颅内感染的最佳证据。文献检索年限为2013-2023年,由两名经过培训的研究生评估文献质量,提取和综合证据。结果共纳入文献17篇,其中3篇指南,5篇专家共识,8篇系统评价,1篇随机对照试验;获得3个维度(置管前、置管中、置管后)的管理策略,共20条证据,包括脑脊液外引流管置管前准备、置管中注意事项及置管后处理等预防颅内感染的策略。结论临床上对脑脊液外引流管的管理存在一定差异,需制定统一、规范、合理的预防颅内感染的集束化策略,以降低导管相关颅内感染的发生率。

Objective To retrieve and extract the best evidence for preventing intracranial infections related to external cerebrospinal fluid(CSF)drainage,and provide evidence-based support for reducing the incidence of intracranial infection caused by external CSF drainage.Methods Evidence-based care issues were determined according to PIPOST,and the best evidence on intracranial infection related to external CSF drainage tube was retrieved from top to bottom.The literature retrieval period was 2013-2023.Quality control of the literatures,as well as extraction and summary of the evidence were carried out by 2 trained graduate students.Results A total of 17 literatures were included in the analysis,including 3 guidelines,5 expert consensus,8 systematic reviews,and 1 randomized controlled trial.Management strategies from 3 dimensions(pre-catheterization,in-catheterization and post-catheterization)were obtained,including 20 pieces of evidence for preventing intracranial infection,such as preparation for external CSF drainage tube,precautions during catheterization,and post-catheterization disposal.Conclusion There are differences in the management of external CSF drainage tube in clinical practice.It is necessary to develop unified,standardized,and rational bundle strategies to prevent intracranial infection,so as to reduce the incidence of catheter-related intracranial infection.