缺血性卒中患者预防肺栓塞的最佳证据总结

doi:10.3969/j.issn.1673-5765.2021.12.011

摘要/Abstract

摘要： 目的总结缺血性卒中患者预防肺栓塞的最新、最佳证据，为临床护理实践提供循证依据。方法计算机检索BMJ最佳实践（BMJ Best Practice）、UpToDate、英国国家卫生与临床优化指南库（National Institute for Health and Care Excellence，NICE）、PubMed、Cochrane Library和中国知网等21个数据库和指南网站关于预防缺血性卒中患者肺栓塞的指南、临床决策、最佳实践、证据总结、系统评价、专家共识和随机对照试验，检索文献的发表时间为2010年1月-2021年7月。采用临床指南研究与评价系统Ⅱ（appraisal of guidelines for research and evaluation Ⅱ，AGREE Ⅱ）、系统评价评估系统（assessment of multiple systematic reviews 2，AMSTAR 2）和澳大利亚Joanna Briggs循证卫生保健中心（Joanna Briggs Institute，JBI）文献质量评价标准对相应文献进行评价，并采用JBI的证据分级系统对纳入证据进行证据分级和证据推荐。结果共纳入28篇文献，其中指南17篇、系统评价4篇、专家共识4篇、随机对照试验2篇、证据总结1 篇。分别从入院评估、健康宣教、基本预防、机械预防、药物预防、病情监测6个维度总结了共计28条最佳证据。结论缺血性卒中患者预防肺栓塞的证据总结涵盖了自入院评估至出院宣教的全过程，证据生成过程科学，针对性强，可为临床护理实践提供一定参考。

文章导读： 本研究基于循证医学方法论总结了关于缺血性卒中患者预防肺栓塞的最新、最佳证据，证据涵盖自入院评估至出院宣教全过程，证据生成过程科学，针对性强。

关键词: 肺栓塞; 缺血性卒中; 预防; 证据总结; 循证医学

Abstract: Objective To summarize the best evidences of prevention of pulmonary embolism in patients with ischemic stroke, and provide evidence-based reference for clinical nursing practice. Methods A total of 21 database and guideline websites including BMJ Practice, UpToDate, NICE, PubMed, Cochrane Library, CNKI and so on were retrieved for the papers involving prevention of pulmonary embolism in patients with ischemic stroke, including guidelines, clinical decisions, best practices, evidence reviews, systematic reviews, expert consensus and randomized controlled trials (RCTs). The publication time of the retrieved papers was from January 2010 to July 2021. AGREEⅡ, AMSTAR 2 and JBI evidence-based health care center literature quality evaluation criteria were used to evaluate the literatures, and the evidence grading system of JBI evidencebased health care center was used for the evidence grading and evidence recommendation. Results A total of 28 literatures were pooled, including 17 guidelines, 4 systematic reviews, 4 expert consensus, 2 RCTs, and 1 evidence summary. A total of 28 best evidences were summarized from 6 dimensions of admission assessment, health education, basic prevention, mechanical prevention, drug prevention, and disease monitoring. Conclusions The evidences for prevention of pulmonary embolism in patients with ischemic

stroke covered the whole process from admission evaluation to discharge health education. The

evidence generation process was scientific and highly targeted, which can provide reference for clinical nursing practice.

Key words: Pulmonary embolism; Ischemic stroke; Prevention; Evidence summary; Evidencebased medicine

杨慕维, 刘高, 和意娴, 郭清源, 蔡恩丽. 缺血性卒中患者预防肺栓塞的最佳证据总结[J]. 中国卒中杂志, 2021, 16(12): 1259-1267.

YANG Muwei, LIU Gao, HE Yixian, GUO Qingyuan, CAI Enli. Pooled Analysis of Best Evidences of Prevention of Pulmonary Embolism in Patients with Ischemic Stroke[J]. Chinese Journal of Stroke, 2021, 16(12): 1259-1267.

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