以质量求发展,以服务铸品牌

护理学报 ›› 2018, Vol. 25 ›› Issue (21): 33-39.doi: 10.16460/j.issn1008-9969.2018.21.033

• 循证护理 • 上一篇    下一篇

肿瘤患者术中非计划性低体温预防及管理的证据总结

黄培培1, 米元元2, 吴白女1, 陈肖敏3a, 周明3b, 鲍映雪3b, 张琼3b, 杨喜群3b, 史平1   

  1. 1.湖州师范学院医学院 护理学院,浙江 湖州 313000;
    2.华中科技大学同济医学院附属协和医院 重症医学科,湖北 武汉 430022;
    3.浙江省人民医院/杭州医学院附属人民医院 a.护理部;b.手术室,浙江 杭州310014
  • 收稿日期:2018-06-03 发布日期:2020-07-08
  • 通讯作者: 史 平(1963-),女,浙江海宁人,本科学历,副教授,硕士研究生导师。
  • 作者简介:黄培培(1993-),女,安徽阜阳人,本科学历,硕士研究生在读,护师。
  • 基金资助:
    浙江省医药卫生平台计划(学科带头人)(2015DTA002)

  • Received:2018-06-03 Published:2020-07-08

摘要: 目的 检索并获取肿瘤患者术中非计划性低体温的相关证据,为手术室护理人员提供参考,以降低肿瘤患者术中非计划性低体温的发生率。方法 应用循证建立PICO的方法,针对肿瘤手术患者围术期术中非计划性低体温提出问题,并使用计算机检索关于术中非计划性低体温的高级别证据,包括指南、专家共识、系统评价、随机对照试验研究。结果 共纳入证据13篇,包括临床实践指南2篇,专家共识1篇,系统综述5篇,随机对照试验5篇,最终提取28条证据,总结出15条最佳证据。结论 建议临床医务人员在应用证据时,结合所在临床科室的环境,评估证据应用时的潜在相关资源及其促进和障碍性因素,患者的主观意愿等进行针对性的选择证据。同时,由于研究的不断发展和推进,应用者还应持续对证据进行更新,最终通过应用最佳证据,以科学的护理方法解决肿瘤患者术中非计划性低体温的问题,从而促进护理质量的持续改进,改善患者的临床结局,提升患者的满意度。

关键词: 肿瘤, 非计划性低体温, 手术, 循证护理

中图分类号: 

  • R246.5
[1] Kelly Putnam.Prevention of Unplanned Patient Hypothermia[J]. AORN Journal,2015,102(4):11-12.DOI:10.1016/S0001-2092(15)00821-2.
[2] Wetz A J, Perl T, Brandes I F, et al.Unexpectedly High Incidence of Hypothermia before Induction of Anesthesia in Elective Surgical Patients[J]. J Chin Anesth, 2016, 34(17): 282-289. DOI:10.1016/j.jclinane.2016.03.065.
[3] 徐彦,陈茜,陆建平,等. 术后苏醒室低体温发生率及危险因素[J]. 复旦学报(医学版), 2016,43(3):302-307.
[4] Kim P, Taghon T, Fetzer M, et al.Perioperative Hypothermia in the Pediatric Population:a Quality Improvement Project[J]. Am J Med Qual,2013, 28(5):400-406.DOI:10.1177/1062860612473350.
[5] Yi J, Zhan L, Lei Y, et al.Establishment and Validation of a Prediction Equation to Estimate Risk of Intraoperative Hypothermia in Patients Receiving General Anesthesia[J]. Scientific Reports,2017, 7(1):1-8.DOI:10.1038/s41598-017-12997-x.
[6] 董妞,商临萍,付秀荣,等. 手术室护士围术期非计划性低体温防护知信行调查及分析[J]. 中国护理管理, 2017,17(10):1414-1417.DOI:10.3969/j.issn.1672-1756.2017.10.028.
[7] Dicenso A, Bayley L, Haynes R B.Accessing Pre-appraised Evidence: Fine-tuning the 5S Model into a 6S Model[J]. Evid Based Nurs,2009, 12(4):99-101.DOI:10.1136/ebn.12.4.99-b.
[8] Brouwers M C, Kho M E, Browman G P, et al.AGREE II: Advancing Guideline Development, Reporting and Evaluation in Health Care[J]. CMAJ, 2010,182(18):839-842. DOI:10. 1503/ cmaj. 090449.
[9] The Joanna Briggs Institute(JBI).Critical Appraisal Tools [EB/OL].(2017-07-15)[2017-11-24].http://joannabriggs.org/research/critical-appraisal-tools.html.
[10] 熊俊,陈日新. 系统评价/Meta分析方法学质量的评价工具AMSTAR[J]. 中国循证医学杂志,2011,11(9):1084-1089.
[11] 米元元,沈月,郝彬,等. ICU患者肠内营养支持并发腹泻的循证护理实践[J].中华护理杂志, 2017, 52(11): 1291-1298.DOI:10.3761/j.issn.0254-1769.2017.11.002.
[12] Birch D W, Dang J T, Switzer N J, et al.Heated Insufflation with or without Humidification for Laparoscopic Abdominal Surgery (Review)[J]. Cochrane Database of Syst Rev,2016,10(10):1-102.DOI:10.1002/14651858.CD007821.pub3.
[13] Wu Q, Zhang Y, Yang Y, et al.Intraoperative Infusion of Branched-chain Amino Acids in Patients undergoing Gastrointestinal Tumor Surgery[J]. World J Surg Oncol,2015,13(1):336-342. DOI:10.1186/s12957-015-0751-y.
[14] Fujita T, Okada N, Kanamori J, et al.Thermogenesis Induced by Amino Acid Administration Prevents Intraoperative hypothermia and Reduces Postoperative Infectious Complications After Thoracoscopic Esophagectomy[J]. Dis Esophagus,2016,30(1):1-7.DOI:10.1111/dote.12460.
[15] Galvão C M, Marck P B, Sawada N O, et al.A Systematic Review of the Effectiveness of Cutaneous Warming Systems to Prevent Hypothermia[J]. J Clin Nurs,2009,18(5):627-636. DOI:10.1111/j.1365-2702.2008.02668.x.
[16] Moola S, Lockwood C.The Effectiveness of Strategies for the Management and/or Prevention of Hypothermia within the Adult Perioperative Environment: Systematic Review[J]. JbI Libr of Syst Rev, 2011, 8(19):752-792.DOI:10.11124/01938924-201008190-00001.
[17] Lopes I G, Magalhães A M S, de Sousa A L A, et al. Preventing Perioperative Hypothermia: An Integrative Literature Review[J]. Revista De Enfermagem Referência, 2015, 112(10):147-155. DOI:10.12707/RIV14027.
[18] Huh J, Cho Y B, Yang M K, et al.What Influence does intermittent Pneumatic Compression of the Lower Limbs Intraoperatively have on Core Hypothermia[J]. Surg Endosc,2013,27(6):2087-2093. DOI:10.1007/s00464-012-2715-4.
[19] National Institute for Health and Clinical Excellence. The Management of Inadvertent Perioperative Hypothermia in Adults[CG65][2017-11-24].https://www.nice.org.uk/guidance/cg65.
[20] Pu Y, Cen G, Sun J, et al.Warming with an Underbody Warming System Reduces Intraoperative Hypothermia in Patients undergoing Laparoscopic Gastrointestinal Surgery: a Randomized Controlled Study[J]. Int J of Nurs Stu,2014,51(2):181-189.DOI:10.1016/j.ijnurstu.2013.05.013.
[21] Erdling A, Johansson A.Core Temperature - the Intraoperative Difference Between Esophageal versus Nasopharyngeal Temperatures and the Impact of Prewarming, Age, and Weight: A Randomized Clinical Trial[J]. AANA J,2015,83(2):99-105.
[22] Hopper V D, Chard R, Clifford T, et al.ASPAN 's Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia[J]. J Perianesth Nurs,2010,25(2):271-287. DOI:10. 1016/j.jopan.2009.09.001.
[23] 马正良,易杰. 围手术期患者低体温防治专家共识(2017)[J]. 协和医学杂志,2017,8(6):258-352.DOI:10.3969/j.issn.1674-9081.2017.06.007.
[24] Honours S M B M, Craig Lockwood. Effectiveness of Strategies for the Management and/or Prevention of Hypothermia within the Adult Perioperative Environment[J]. Int l J Evid Based Healthc, 2011, 9(4):337-345.DOI:10.1111/j.1744-1609.2011.00227.x.
[25] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
[26] Yi J, Xiang Z, Deng X, et al.Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey[J]. PLoS One,2015,10(9):1-12.DOI:10.1371/journal.pone.0136136.
[27] Washington G T, Matney J L.Comparison of Temperature Measurement Devices in Post Anesthesia Patients[J]. J Perianesth Nurs,2008,23(1):36-48.DOI:10.1016/j.jopan.2007.10.001.
[28] Morris R H.Influence of Ambient Temperature on Patient Temperatue During Intraabdominal Surgery[J]. Ann Surg,1971,173(2):230-233.
[29] Kurz A.Thermal Care in the Perioperative Period[J]. Best Prac Res Clin Anaesthesiol,2008,22(1):39-62.DOI:10.1016/j.bpa.2007.10.004.
[30] Torrie J J, Yip P, Robinson E.Comparison of Forced-air Warming and Radiant Heating during Transurethral Prostatic Resection under Spinal Anaesthesia[J]. Anaesth Intensive Care, 2005, 33(6):733-738.
[31] Grocott H P, Mathew J P, Carver E H,et al.A Randomized Controlled Trial of the Arctic Sun Temperature Management System versus Conventional Methods for Preventing Hypothermia during Off-pump Cardiac Surgery[J]. Anesth & Analgesia, 2004, 98(2):298-302.DOI:10.1213/01. ANE. 0000096242.06561.C0.
[32] T Perl, L Flöther,W Weyland,et al.Comparison of Forced-air Warming and Resistive Heating[J]. Minerva Anestsio, 2008,74(12):687-690.
[33] 米元元,沈月,黄海燕,等.ICU患者肠内营养并发腹泻的证据汇总[J].护理学报, 2017, 24(21):58-66.DOI:10.16460/j.issn1008-9969.2017.21.058.
[1] 李丹妮, 邱丽燕, 吴隆燕, 谭铮可可, 陈欣, 杨丽. 前交叉韧带损伤日间手术患者恐动症的潜在剖面分析及影响因素研究[J]. 护理学报, 2025, 32(4): 12-17.
[2] 田美雨, 王翠玲, 高若男, 田佳, 刘怡. 妇科肿瘤科护士性健康照护培训方案的构建[J]. 护理学报, 2025, 32(4): 18-23.
[3] 杜易梅, 刘莉, 郭立丽, 卢吉, 付苗苗, 刘杰. 妇科恶性肿瘤患者性健康研究进展[J]. 护理学报, 2025, 32(4): 28-33.
[4] 张静, 彭焕椽, 陈佳, 鲁永锦, 刘克玄, 侯晓敏. 成人体外循环心脏手术患者预防手术部位感染的最佳证据总结[J]. 护理学报, 2025, 32(4): 41-47.
[5] 李垚, 陈小敏, 夏敏, 吴茜, 张琳, 陈叡喆, 葛莉丽, 吴逸梅. 肿瘤患者衰弱评估工具应用的范围综述[J]. 护理学报, 2025, 32(4): 48-52.
[6] 刘璐, 朱钰, 曹义, 张华, 彭玉娜. 腹腔热灌注化疗患者术中实施不同目标体温管理的效果观察[J]. 护理学报, 2025, 32(4): 59-63.
[7] 郝瑞霞, 王秀梅, 蔚玲, 郭越, 张学. 磁性医院管理理念对手术室护士出勤主义行为的影响[J]. 护理学报, 2025, 32(3): 27-31.
[8] 李若雨, 刘鑫, 林萍, 陈丹, 林桦. 出院患者用药安全管理的最佳证据总结[J]. 护理学报, 2025, 32(3): 50-55.
[9] 杨小娟, 毛孝容, 王静, 江华, 李蓉, 樊宇, 文青, 李林章, 陈晓容. 成人重度烧伤患者早期肠内营养管理的最佳证据总结[J]. 护理学报, 2025, 32(3): 56-61.
[10] 刘硕怡, 熊莉娟, 李凌, 王玉梅, 何嘉, 李鑫, 袁淑蕾, 郭雪琴, 王暘婧, 张慧娟. 老年住院患者衰弱预防及管理临床实践指南的质量评价及内容分析[J]. 护理学报, 2025, 32(2): 50-55.
[11] 闫亚铃, 乐美妮, 姚桃琴, 王雪莲, 姜建玲, 辛艺. 老年胃肠肿瘤患者围手术期衰弱管理方案的构建[J]. 护理学报, 2025, 32(2): 74-78.
[12] 毕雅昕, 端烨, 何丽君, 徐秒, 龚荣花. 减重代谢术后骨质疏松症预防与管理的最佳证据总结[J]. 护理学报, 2025, 32(1): 44-49.
[13] 王子萱, 原振青, 赵一鋆, 王惠平, 洪菲菲, 邹敏. 体面劳动感在三级甲等医院手术室护士反思能力与创新行为的中介效应[J]. 护理学报, 2025, 32(1): 62-67.
[14] 陈莹莹, 丁红, 张根生. 患儿术后谵妄影响因素的研究进展[J]. 护理学报, 2024, 31(9): 32-35.
[15] 陈洁, 孟庆童, 刘惊今, 吴艳妮. 基于指南的慢性心力衰竭患者运动康复科普手册研制[J]. 护理学报, 2024, 31(9): 36-41.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!