以质量求发展，以服务铸品牌

护理学报 ›› 2024, Vol. 31 ›› Issue (4): 48-53.doi: 10.16460/j.issn1008-9969.2024.04.048

• 循证护理 • 上一篇    下一篇

局部枸橼酸抗凝在连续性肾脏替代治疗中的应用及管理的最佳证据总结

杨建国1a, 何细飞1b, 鄢建军1a, 张梦1b, 杨纯子1c, 徐蓉1c, 王艳芳2   

  1. 1.华中科技大学同济医学院附属同济医院 a.血液净化中心,b.内科教研室,c.护理部,湖北 武汉 430030;
    2.南方医院JBI循证护理合作中心,广东 广州 510515
  • 收稿日期:2023-09-24 出版日期:2024-02-25 发布日期:2024-03-07
  • 通讯作者: 何细飞（1979-）,女,湖北武汉人,硕士,副主任护师,硕士研究生导师,总护士长。E-mail:26817600@qq.com
  • 作者简介:杨建国（1987-）,男,湖北武汉人,硕士,主管护师,循证护理师。

Best evidence summary for application and management of regional citrate anticoagulation in continuous renal replacement therapy

YANG Jian-guo1a, HE Xi-fei1b, YAN Jian-jun1a, ZHANG Meng1b, YANG Chun-zi1c, XU Rong1c, WANG Yan-fang2   

  1. 1a. Blood Purification Center; 1b. Teaching and Research Office of Internal Medicine, 1c. Dept. of Nursing Administration, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;
    2. JBI Evidence-based Nursing Cooperation Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Received:2023-09-24 Online:2024-02-25 Published:2024-03-07

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摘要： 目的 总结基于局部枸橼酸抗凝的连续性肾脏替代治疗（Regional Citrate Anticoagulation-Continuous Renal Replacement Therapy, RCA-CRRT）的临床应用及管理的最佳证据,为临床工作提供证据支持。方法 遵循JBI循证护理中心的临床证据实践应用系统的标准程序,检索相关指南网站、数据库以及专业领域学术网站中关于RCA-CRRT的临床实践指南、证据综合、专家共识及系统评价类文献,并对符合质量标准的文献进行证据提取及整合。结果 共纳入18篇文献,包括证据总结3篇、临床决策1篇、临床指南2篇、专家共识2篇和系统评价10篇,最后从适用范围、方案制定、参数设置、过程监测、导管维护和质量控制6个方面形成了40条最佳证据。结论 临床上进行局部枸橼酸抗凝的连续性肾脏替代治疗时,可参考本研究总结的6个方面中40条证据,制定个性化的治疗方案,操作过程中密切监测治疗及抗凝效果,为患者提供高质量护理。

关键词: 局部枸橼酸抗凝, 连续性肾脏替代治疗, 证据总结, 循证护理

Abstract: Objective To summarize the best evidence for the clinical application and management of regional citrate anticoagulation in continuous renal replacement therapy (RCA-CRRT). Methods Relevant guideline websites, databases and academic websites were systematically searched for the literature related to RCA-CRRT. Evidence extraction and integration from eligible literature was performed. Results Eighteen articles were included, including 3 evidence synthesis, 1 clinical decision, 2 clinical guidelines, 2 expert consensuses and 10 systematic reviews. Finally, 40 pieces of best evidence were formed from 6 aspects: scope of application, protocol development, parameter setting, process monitoring, catheter maintenance, and quality control. Conclusion To provide high-quality care for patients when conducting RCA-CRRT, personalized treatment plans and close monitoring of the treatment and coagulation can be developed by referring to the best evidence.

Key words: regional citrate anticoagulation, continuous renal replacement therapy, evidence summary, evidence-based nursing

中图分类号: 

  • R473.5
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