加速康复外科理念下肺切除术患者围手术期液体管理的最佳证据总结

doi:10.16460/j.issn1008-9969.2023.15.058

摘要/Abstract

摘要： 目的检索、评价、整合加速康复外科理念下肺切除术患者围手术期液体管理最佳证据。方法依据PIPOST模式,按照“6S”证据模型系统检索关于加速康复理念下肺切除手术围手术期液体管理的所有证据,包括指南、专家共识、系统评价、Meta分析等。由4名经过循证培训的研究者独立完成文献质量评价,对符合质量标准的文献进行证据提取并汇总。结果最终纳入14篇文献,包括4篇指南、3篇专家共识、5篇系统评价、2篇Meta分析,从液体治疗策略、术前液体治疗、术中液体治疗、术后液体治疗、复苏性液体治疗、评估与监测6个方面汇总17条最佳证据。结论本研究从6个方面总结了加速康复外科理念下肺切除术患者围手术期液体管理最佳证据17条,为临床护理实践提供理论依据,指导临床护士实施液体管理与护理。

关键词: 肺切除术, 液体管理, 围手术期, 加速康复外科, 循证护理学

中图分类号:

R473.6

张洁苹, 项丹玉, 高雯霞, 缪园, 王嵌, 杭琳. 加速康复外科理念下肺切除术患者围手术期液体管理的最佳证据总结[J]. 护理学报, 2023, 30(15): 58-63.

参考文献

[1] Alexander M, Kim SY, Cheng H.Update 2020:management of non-small cell lung cancer[J]. Lung,2020,198(6):897-907.DOI: 10.1007/s00408-020-00407-5.
[2] Deboever N, Mitchell KG, Feldman HA, et al.Current surgical indications for non-small-cell lung cancer[J]. Cancers (Basel),2022,14(5):1263. DOI:10.3390/cancers14051263.
[3] 胡雁,郝玉芳.循证护理学[M].北京:人民卫生出版社,2018.
[4] 周芬,郝玉芳,丛雪,等.指南研究与评价工具AGREEⅡ及各领域分值的补充解释及思考[J].护理学报,2018,25(18):56-58. DOI:10.16460/j.issn1008-9969.2018.18.056.
[5] Shea BJ, Reeves BC, Wells G, et al.AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both[J]. BMJ,2017,358:j4008. DOI:10.1136/bmj.j4008.
[6] 陶欢,杨乐天,平安,等.随机或非随机防治性研究系统评价的质量评价工具AMSTAR 2解读[J].中国循证医学杂志,2018,18(1):101-108. DOI:10.7507/1672-2531.201711005.
[7] Aromataris E, Munn P.Joanna briggs institute reviewer’s manual[M]. Adelaide, Australia: The Joanna Briggs Institutetute, 2017.
[8] 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. DOI:10.16821/j.cnki.hsjx.2015.11.002.
[9] National Institute for Health and Care Excellence. National institute for health and care excellence: clinical guidelines. Lung cancer: diagnosis and management[S]. London :National Institute for Health and Care Excellence,2019.
[10] 赵玉沛,黄宇光,杨尹默,等.中国加速康复外科临床实践指南(2021版)[J].中国实用外科杂志,2021,41(9):961-992.DOI: 10.19538/j.cjps.issn1005-2208.2021.09.01.
[11] Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al.Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS ) Society and the European Society of Thoracic Surgeons (ESTS)[J]. Eur J Cardiothorac Surg,2019,55(1):91-115.DOI: 10.1093/ejcts/ezy301.
[12] National Institute for Health and Care Excellence. National institute for health and care excellence: clinical guidelines. Intravenous fluid therapy in adults, in hospital clinical guideline[S]. London:National Institute for Health and Care Excellence,2017.
[13] 王天龙,王东信,李金宝,等.中国老年患者围手术期麻醉管理指导意见(2020版)(二)[J].中华医学杂志,2020,100(33):2565-2578.DOI:10.3760/cma.j.cn112137-20200503-01407.
[14] Navarro LH, Bloomstone JA, Auler JO Jr, et al.Perioperative fluid therapy: a statement from the International Fluid Optimization Group[J]. Perioper Med (Lond), 2015,4:3.DOI: 10.1186/s13741-015-0014-z.
[15] 赵玉沛,杨尹默,楼文晖,等.外科病人围手术期液体治疗专家共识(2015)[J].中国实用外科杂志,2015,35(9):960-966. DOI:10.7504/CJPS.ISSN1005-2208.2015.09.14.
[16] Chong MA, Wang Y, Berbenetz NM, et al.Does goal-directed haemodynamic and fluid therapy improve peri-operative outcomes? A systematic review and Meta-analysis[J]. Eur J Anaesthesiol,2018,35(7):469-483. DOI: 10.1097/EJA.0000000000000778.
[17] Jessen MK, Vallentin MF, Holmberg MJ,et al.Goal-directed haemodynamic therapy during general anaesthesia for noncardiac surgery: a systematic review and Meta-analysis[J]. Br J Anaesth,2022,128(3):416-433.DOI:10.1016/j.bja.2021.10.046.
[18] Nicole Siparsky,Amalia Cochran,Kathryn A, et al.Summary of adult postoperative rehydration therapy.[EB/OL].[2021-10-14][2023-03-15].https://www.uptodate.cn/contents/zh-Hans/overview-of-postoperative-fluid-therapy-in-adults?search=Summary%20of%20adult%20postoperative%20rehydration%20therapy&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2.
[19] Jewer JK, Wong MJ, Bird SJ, et al. Supplemental perioperative intravenous crystalloids for postoperative nausea and vomiting[J]. Cochrane Database of Systematic Reviews, 2019, 3(3):CD012212. DOI:10.1002/14651858.CD012212.2019.
[20] Licker M, Hagerman A, Bedat B, et al.Restricted, optimized or liberal fluid strategy in thoracic surgery: a narrative review[J]. Saudi J Anaesth, 2021,15(3):324-334. DOI: 10.4103/sja.sja_1155_20.
[21] Davies Hugh,Leslie, Gavin, et al.Effectiveness of daily fluid balance charting in comparison to the measurement of body weight when used in guiding fluid therapy for critically ill adult patients: a systematic review protocol[J]. JBI Database System Rev Implement Rep, 2015,13(3):111-123.DOI:10.11124/jbisrir-2015-2010.
[22] Girish P, Michael F, Nancy A, et al.Intraoperative-fluid-management[EB/OL].[2022-04-15][2023-03-15].https://www.uptodate.cn/contents/zh-Hans/intraoperative-fluid-management search=Intraoperative-fluid-management&source=search_result&selectedTitle=1~91&usage_type=default&display_rank=1.
[23] Jeong JY, Ahn JH, Shim JG,et al.Gastric emptying of preoperative carbohydrate in elderly assessed using gastric ultrasonography: a randomized controlled study[J]. Medicine (Baltimore),2021,100(37):e27242.DOI:10.1097/MD.0000000000027242.
[24] Alam N, Park BJ, Wilton A, et al.Incidence and risk factors for lung injury after lung cancer resection[J]. Ann Thorac Surg,2007,84(4):1085-1091.DOI:10.1016/j.athoracsur.2007.05.053.
[25] Seeley EJ.A dry lung is a happy lung: more supporting evidence[J]. J Thorac Cardiovasc Surg, 2015,149(1):321-322. DOI: 10.1016/j.jtcvs.2014.09.021.
[26] 张晓敏,李建立,容俊芳.目标导向液体治疗对肺叶切除术患者的肺保护作用[J].中华麻醉学杂志,2020,40(1):82-86.DOI:10.3760/cma.j.issn.0254-1416.2020.01.020.
[27] Popivanov P, Irwin R, Walsh M,et al.Gastric emptying of carbohydrate drinks in term parturients before elective caesarean delivery: an observational study[J]. Int J Obstet Anesth, 2020,41:29-34. DOI: 10.1016/j.ijoa.2019.07.010.
[28] Assaad S, Kyriakides T, Tellides G, et al.Extravascular lung water and tissue perfusion biomarkers after lung resection surgery under a normovolemic fluid protocol[J]. J Cardiothorac Vasc Anesth,2015,29(4):977-983.DOI:10.1053/j.jvca.2014.12.020.
[29] 何燕,张建友,孙建宏. ERAS理念指导下围术期液体治疗的研究进展[J]. 国际外科学杂志,2021,48(1):67-72. DOI:10.3760/cma.j.cn115396-20200921-00287.
[30] 云麟钧,潘燕,刘嘉欣,等.胸腔镜下肺叶切除术后患者麻醉复苏早期饮水的安全性[J].护理学杂志,2020,35(24):55-57. DOI:10.3870/j.issn.1001-4152.2020.24.055.
[31] 魏小龙,朱文敏.全身麻醉术后患者早期饮水管理策略的最佳证据总结[J].中华急危重症护理杂志,2021,2(6):535-542. DOI:10.3761/j.issn.2096-7446.2021.06.011.
[32] Piper GL, Kaplan LJ.Fluid and electrolyte management for the surgical patient[J]. Surg Clin North Am,2012,92:189. DOI:10.1016/j.suc.2012.01.004.
[33] Martin GS, Kaufman DA, Marik PE, et al.Perioperative Quality Initiative(POQI) consensus statement on fundamental concepts in perioperative fluid management: fluid responsiveness and venous capacitance[J]. Perioper Med (Lond),2020,9:12. DOI:10.1186/s13741-020-00142-8.
[34] Kambhampati G, Ross EA, Alsabbagh, MM, et al.Perioperative fluid balance and acute kidney injury[J]. Clin Exp Nephrol,2012,16:730-738.DOI:10.1007/s10157-012-0623-5.
[35] 付艳芬,王春青,胡雁.证据临床转化中障碍因素和促进因素的内容分析[J].护理学报,2022,29(5):64-68. DOI:10.16460/j.issn1008-9969.2022.05.064.

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