摘要
目的总结国内外肠造口患者造口脱垂预防与管理的最佳证据,为临床预防与管理造口脱垂措施制订提供参考。方法按照循证资源"6S"证据金字塔模型自上而下的原则检索UpToDate、BMJ最佳临床实践、国际指南协作网、英国国家卫生与临床优化研究所、苏格兰院际指南网、美国国立指南网、中国知网、万方数据库、维普数据库、中国生物医学等数据库及网站中关于肠造口患者造口脱垂预防与管理的证据,检索时限为2017年1月30日到2023年5月30日,由2名研究者独立完成证据的质量评价,并对证据进行提取与整合。结果共纳入10篇文献,包括临床决策1篇、指南5篇、专家共识1篇、最佳证据总结1篇、系统评价1篇、立场声明1篇。总结的最佳证据包括围手术期评估、术前造口定位、降低腹压、造口脱垂处理、健康教育和随访5个方面,共20条证据。结论该研究总结的肠造口患者造口脱垂预防与管理的最佳证据可为临床实践提供循证依据,但在应用过程中需结合临床情景及患者意愿,制订个性化的肠造口患者造口脱垂预防管理方案。
Objective To summarize the relevant evidence for prevention and management of stoma prolapse in patients with enterostomy,so as to provide reference for the clinical prevention and management of stoma prolapse measures.Methods According to the evidence-based resource"6S"evidence pyramid model,systematically searched about the evidence of enterostomy patients prolapse prevention and management in UpToDate,BMJ best practice,Guidelines International Network,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,CNKI,Wanfang database,VIP Database,SinoMed,etc.The search time limit was from 30 January 2017 to 30 May 2023,2 researchers independently evaluated the quality of the literature,selected and extracted the evidence.Results A total of ten articles were included,including one clinical decision,five guidelines,one expert consensus,one evidence,one systematic review,one position statement.Through analysis,20 best evidences were identified,including perioperative evaluation,preoperative colostomy site marking,reducing abdominal pressure,enterostomy prolapse nursing,health education and the follow-up.Conclusions Best evidence summary for the prevention and care of stoma prolapse in enterostomy patients provides evidence-based reference for clinical application.Nurses should carefully select and apply evidence in combination with clinical situations and patients′wishes,so as to develop a personalised stoma prolapse prevention and management programme for patients with enterostomy.
作者
赵飞飞
胡锦晨
黄虹
刘琳
黄小红
Zhao Feifei;Hu Jinchen;Huang Hong;Liu Lin;Huang Xiaohong(Shenzhen Clinical Medical College,Guangzhou University of Chinese Medicine,Shenzhen 518116,China;Department of Nursing,Longgang Central Hospital of Shenzhen,Shenzhen 518116,China)
出处
《中国实用护理杂志》
2024年第10期779-785,共7页
Chinese Journal of Practical Nursing
关键词
肠造口术
造口脱垂
预防
护理
循证护理学
Enterostomy
Stoma prolapse
Prevention
Nursing care
Evidence-based nursing
作者简介
通信作者:黄小红,Email:stone107@126.com。
