成人气管插管患者发生非计划性拔管的危险因素评估和预防策略系统评价
发布时间：2018-08-28 08:30
【摘要】：目的:通过对成人气管插管患者发生非计划性拔管的相关文章进行检索、评定并进行系统评价,提出了成人气管插管患者发生非计划性拔管的危险因素的评估和预防策略,以期为临床非计划性拔管的评估和干预提供依据。方法:通过对 Cochrane、PubMed、SCOPUS、CINAHL、EBSCO、MEDLINE、CBM、CNKI中国知网、万方等数据库已经公开发表的文献数据进行检索,检索时限:2005年1月1日到2017年1月31日。检索Cochrane图书馆是否有相关的系统评价、Meta分析,在各数据库中检索相关的原始文献,对文献的题目、摘要、关键词、主题词及参考文献进行分析,确定文献检索的关键词。主题词与自由词结合,及时参考检索到的文献,不断扩充同义检索词。确定英文检索词:(unplanned extubation or unexpected extubation or unscheduled extubation or unintended extubation or inadvertent extubation or unintentional extubation or self-extubation or airway accident)and(mechanical ventilation or artificial respiration or intubation);中文检索词:非计划性拔管OR意外拔管OR自行拔管。对检索结果进行严格筛选,最后选出符合要求的文献,由2位研究员采用美国约翰霍普金斯证据等级与质量评价方法独立对相关文献进行等级和质量评定,然后进行数据收集和分析。研究结果:纳入50篇文献的质量与等级评定结果,Level ⅠB 1篇;Level ⅡA1篇;Level ⅡB 6篇;Level ⅢA 31篇;Level ⅢB 7篇;Level ⅣA 4篇,通过系统分析和归纳出成人气管插管患者发生非计划性拔管的危险因素和预防策略。危险因素包括患者相关的危险因素:躁动/谵妄、意识水平、疾病种类和严重程度、其他因素(APACHEⅡ、男性);护理相关的危险因素:气管导管的固定方法、床边监测的减少、护理操作程序、护患比例及护士经验;镇静相关的危险因素:镇静不充分、镇静药物;身体约束具的使用;发生非计划性拔管的高危时间段。预防非计划性拔管策略包括员工的教育策略;危险因素评估策略;气管导管固定方法和监测策略;镇静、镇痛协议策略;撤机协议策略;身体约束具策略和管理策略。研究结论:建立一套成人气管插管患者发生非计划性拔管的危险因素的评估和预防非计划性拔管策略,对降低气管插管患者的非计划性拔管发生是行之有效的方法。
[Abstract]:Objective: to evaluate and systematically evaluate the risk factors of unplanned extubation in adult patients with tracheal intubation by searching, evaluating and systematically evaluating the risk factors of unplanned extubation in adult tracheal intubation patients. In order to provide the basis for clinical unplanned extubation evaluation and intervention. Methods: through the retrieval of the published literature data of Cochrane,PubMed,SCOPUS,CINAHL,EBSCO,MEDLINE,CBM,CNKI China knowledge Network, Wanfang and other databases, the time limit of retrieval was from January 1, 2005 to January 31, 2017. Search the Cochrane library for systematic evaluation and meta analysis, search the related original documents in each database, analyze the titles, abstracts, keywords, subject words and references of the literature, and determine the keywords of the literature retrieval. Subject words combined with free words, timely reference to the retrieval of literature, expanding synonymous search words. Determine the English key word: (unplanned extubation or unexpected extubation or unscheduled extubation or unintended extubation or inadvertent extubation or unintentional extubation or self-extubation or airway accident) and (mechanical ventilation or artificial respiration or intubation);: unplanned extubation OR unintentional extubation OR self-extubation. The retrieval results were strictly screened, and the documents that met the requirements were selected. The relevant documents were evaluated independently by two researchers using the Johns Hopkins evidence rating and quality evaluation method in the United States. Data are then collected and analyzed. Results: the results of quality and grade evaluation of 50 articles included: level 鈪，
本文编号：2208847
[Abstract]:Objective: to evaluate and systematically evaluate the risk factors of unplanned extubation in adult patients with tracheal intubation by searching, evaluating and systematically evaluating the risk factors of unplanned extubation in adult tracheal intubation patients. In order to provide the basis for clinical unplanned extubation evaluation and intervention. Methods: through the retrieval of the published literature data of Cochrane,PubMed,SCOPUS,CINAHL,EBSCO,MEDLINE,CBM,CNKI China knowledge Network, Wanfang and other databases, the time limit of retrieval was from January 1, 2005 to January 31, 2017. Search the Cochrane library for systematic evaluation and meta analysis, search the related original documents in each database, analyze the titles, abstracts, keywords, subject words and references of the literature, and determine the keywords of the literature retrieval. Subject words combined with free words, timely reference to the retrieval of literature, expanding synonymous search words. Determine the English key word: (unplanned extubation or unexpected extubation or unscheduled extubation or unintended extubation or inadvertent extubation or unintentional extubation or self-extubation or airway accident) and (mechanical ventilation or artificial respiration or intubation);: unplanned extubation OR unintentional extubation OR self-extubation. The retrieval results were strictly screened, and the documents that met the requirements were selected. The relevant documents were evaluated independently by two researchers using the Johns Hopkins evidence rating and quality evaluation method in the United States. Data are then collected and analyzed. Results: the results of quality and grade evaluation of 50 articles included: level 鈪，
本文编号：2208847
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