目的:检索、评价并总结成人体外膜氧合(ECMO)撤机策略的相关证据,为临床实践提供依据。方法:计算机检索Web of Science、Embase、Cochrane图书馆、PubMed、万方数据库、中国知网、维普网、中国生物医学文献服务系统、英国医学杂志最佳...目的:检索、评价并总结成人体外膜氧合(ECMO)撤机策略的相关证据,为临床实践提供依据。方法:计算机检索Web of Science、Embase、Cochrane图书馆、PubMed、万方数据库、中国知网、维普网、中国生物医学文献服务系统、英国医学杂志最佳临床实践数据库(BMJ Best Practice)、英国国家卫生与临床优化研究所(NICE)指南库、乔安娜布里格斯研究所(JBI)循证卫生保健中心数据库、UpToDate以及美国卫生保健研究与质量机构(AHRQ)、美国重症医学会(SCCM)、美国重症护理协会(AACN)、欧洲重症医学会(ESICM)、体外生命支持组织(ELSO)等机构网站中与ECMO撤机相关的随机对照试验、系统评价、指南、证据总结、专家共识、临床决策,检索时限为建库至2023年7月。由循证团队进行文献筛选、质量评价、证据提取和总结。结果:共纳入13篇文献,包括4篇指南、4篇专家共识、3篇临床决策、2篇系统评价,形成42条关于成人ECMO撤机策略的证据,包括建议在静脉-静脉体外膜氧合(V-V ECMO)撤机前评估患者能否充分进行气体交换、当静脉-动脉体外膜氧合(V-A ECMO)患者心功能基本恢复时应尽早撤机等,内容涉及团队建立、抗凝管理、评估、撤机实施、管路与伤口管理、质量控制6个方面。结论:本研究对成人ECMO撤机策略进行了文献总结,为规范ECMO撤机提供了参考信息。建议结合医院实际情况构建ECMO团队,应用当前证据规范ECMO撤机流程,从而提高ECMO患者的救治成功率。展开更多
In retrospect of foreign literature studies in China from 1949 to 2019,we have to acknowledge two fundamental facts.Firstly,although in the initial 30 years of this period foreign literature studies in China largely f...In retrospect of foreign literature studies in China from 1949 to 2019,we have to acknowledge two fundamental facts.Firstly,although in the initial 30 years of this period foreign literature studies in China largely followed the Soviet model,neglecting Western literary and cultural traditions to some extentwith over a decade under the influence of extreme"leftist"trendsit was during this time that the groundwork for the academic framework of foreign literature studies was painstakingly laid.Secondly,with the influx of Western ideas,foreign literature studies during the subsequent 40 years underwent a complete paradigm shift,providing the spiritual nourishment for and playing a pioneering role in liberating thought and rectifying disorders.However,this period saw a conspicuous adoption of Western paradigms in foreign literature studies,thereby somewhat abandoning certain valuable traditions and academic stances that ought to have been upheld.Meanwhile,foreign literature studies in this period also experienced an undiscriminating acceptance and hasty integration of ideas,leading to a mixture of the good and the bad.This essay provides an important overview of 70 years of foreign literature studies in China,though the specific situations are much more complex.In recent years,as the ideas of cultural confidence and a community of shared future for mankind deeply resonate with the public,the principles of serving the Chinese people and Chinese socialist cause are increasingly becoming significant recognitions within China's foreign literature scholarly community.展开更多
文摘目的:检索、评价并总结成人体外膜氧合(ECMO)撤机策略的相关证据,为临床实践提供依据。方法:计算机检索Web of Science、Embase、Cochrane图书馆、PubMed、万方数据库、中国知网、维普网、中国生物医学文献服务系统、英国医学杂志最佳临床实践数据库(BMJ Best Practice)、英国国家卫生与临床优化研究所(NICE)指南库、乔安娜布里格斯研究所(JBI)循证卫生保健中心数据库、UpToDate以及美国卫生保健研究与质量机构(AHRQ)、美国重症医学会(SCCM)、美国重症护理协会(AACN)、欧洲重症医学会(ESICM)、体外生命支持组织(ELSO)等机构网站中与ECMO撤机相关的随机对照试验、系统评价、指南、证据总结、专家共识、临床决策,检索时限为建库至2023年7月。由循证团队进行文献筛选、质量评价、证据提取和总结。结果:共纳入13篇文献,包括4篇指南、4篇专家共识、3篇临床决策、2篇系统评价,形成42条关于成人ECMO撤机策略的证据,包括建议在静脉-静脉体外膜氧合(V-V ECMO)撤机前评估患者能否充分进行气体交换、当静脉-动脉体外膜氧合(V-A ECMO)患者心功能基本恢复时应尽早撤机等,内容涉及团队建立、抗凝管理、评估、撤机实施、管路与伤口管理、质量控制6个方面。结论:本研究对成人ECMO撤机策略进行了文献总结,为规范ECMO撤机提供了参考信息。建议结合医院实际情况构建ECMO团队,应用当前证据规范ECMO撤机流程,从而提高ECMO患者的救治成功率。
文摘In retrospect of foreign literature studies in China from 1949 to 2019,we have to acknowledge two fundamental facts.Firstly,although in the initial 30 years of this period foreign literature studies in China largely followed the Soviet model,neglecting Western literary and cultural traditions to some extentwith over a decade under the influence of extreme"leftist"trendsit was during this time that the groundwork for the academic framework of foreign literature studies was painstakingly laid.Secondly,with the influx of Western ideas,foreign literature studies during the subsequent 40 years underwent a complete paradigm shift,providing the spiritual nourishment for and playing a pioneering role in liberating thought and rectifying disorders.However,this period saw a conspicuous adoption of Western paradigms in foreign literature studies,thereby somewhat abandoning certain valuable traditions and academic stances that ought to have been upheld.Meanwhile,foreign literature studies in this period also experienced an undiscriminating acceptance and hasty integration of ideas,leading to a mixture of the good and the bad.This essay provides an important overview of 70 years of foreign literature studies in China,though the specific situations are much more complex.In recent years,as the ideas of cultural confidence and a community of shared future for mankind deeply resonate with the public,the principles of serving the Chinese people and Chinese socialist cause are increasingly becoming significant recognitions within China's foreign literature scholarly community.
