主动脉外科术后患者脊髓损伤预防及管理的最佳证据总结

Evidence summary for prevention and management of spinal cord injury after aortic surgery

目的汇总主动脉外科术后患者脊髓损伤预防及管理的最佳证据,以期为临床实践提供参考。方法针对主动脉外科术后患者脊髓损伤预防及管理相关问题,系统检索计算机决策系统、指南网站、专业协会网站和数据库中的临床决策、最佳实践、证据总结、指南、专家共识、系统评价、随机对照试验和类试验研究等,检索时限为建库至2022年12月31日。由2名研究人员对文献进行筛选和质量评价,对纳入文献进行资料提取与证据汇总。结果共纳入文献22篇,汇总出20条主动脉外科术后患者脊髓损伤预防及管理的证据,包括脊髓损伤的评估与监测、风险因素识别、预防与管理措施3个方面的证据。结论该研究总结了目前关于主动脉外科术后脊髓损伤预防及管理的最佳证据,可为临床医疗及护理实践提供循证依据。目前证据大多来自于国外,未来仍需进一步开展国内护理领域相关高质量研究。通过应用最佳证据,用科学的方法预防和管理主动脉外科术后脊髓损伤,提升护理质量,改善患者结局。

Objective To summarize the best evidence for prevention and management of spinal cord injury in patients after aortic surgery,so as to provide reference for clinical practice.Methods For the prevention and management of spinal cord injury in patients after aortic surgery,the clinical decisions,best practices,evidence summaries,guidelines,expert consensuses,systematicr reviews,randomized controlled trials,and quasi-experimental studies were systematically searched in computer decision-supporting system,guideline websites,association official websites and databases.The search deadline was from database establishment to December 31,2022.Two researchers screened and evaluated the methodological quality of included literature,and extracted and summarized the evidence.Results Twenty-two articles were included in the study.Three dimensions with 20 items of evidence were summarized,including assessment and monitoring of spinal cord injury,risk factors identification,prevention and management strategies.Conclusion This study summarized the best evidence on the prevention and management of spinal cord injury afer aortic surgery,which could provide evidence-based references for clinical and nursing practice.Most of the current evidence came from abroad,therefore,it is necessary to further carry out high-quality nursing researches in China.Through the application of the best evidence,scientific methods are expected to prevent and manage spinal cord injury after aortic surgery,and improve the quality of nursing and outcomes of patients.