血液透析导管相关血流感染预防指南及共识的质量评价和内容分析

doi:10.16460/j.issn1008-9969.2025.05.059

摘要/Abstract

摘要： 目的评价并分析国内外关于血液透析导管相关血流感染预防的指南及专家共识,旨在为临床实践提供科学指导。方法系统性检索国内外数据库、指南网站及专业协会网站,筛选涉及该主题的指南及专家共识,进行质量评价后对内容进行分析。结果共纳入8篇指南,4篇专家共识,其中5篇指南为B级推荐,3篇指南为C级推荐,4篇专家共识均为推荐。指南标准化平均得分为范围与目的55.21%、参与人员36.11%、制定的严谨性31.05%、表达的清晰性58.33%、应用性27.48%、编辑的独立性50.52%、总质量52.60%。将B级指南及推荐专家共识进行内容分析,归纳出6个主题：置管、导管维护、其他预防感染措施、导管拔除、健康教育、培训及质控,共45项推荐内容。结论目前国内外关于血液透析导管相关血流感染预防指南质量大部分为中等,在制定的参与人员、制定的严谨性、应用性方面有待提升。

Abstract: Objective To evaluate and analyze domestic and international guidelines and expert consensus on the prevention of hemodialysis catheter-related bloodstream infections (CRBSIs), and to provide guidance for clinical practice. Methods Systematic search of domestic and international databases, guideline websites and websites of professional associations was conducted to screen the guidelines and expert consensus on hemodialysis CRBSIs, and the AGREE II and JBI evaluation tools were used to evaluate and analyze the contents. Results A total of 8 guidelines and 4 expert consensus were included, of which 5 guidelines were recommended as grade B, 3 guidelines as grade C, and all 4 expert consensus as being recommended. The average score range of guideline standardization was 55.21% for scope and purpose, 36.11% for participants, 31.05% for rigor of formulation, 58.33% for clarity of expression, 27.48% for applicability, 50.52% for editorial independence, and 52.60% for overall quality. Content analysis was conducted in all grade-B guidelines and recommended expert consensus and six topics were summarized as tube placement, catheter maintenance, other infection prevention measures, catheter removal, health education, training and quality control, with a total of 45 recommendations. Conclusion The current domestic and international guidelines on the prevention of hemodialysis CRBSIs are of moderate quality, and need to be improved in terms of participants involved in their development, the rigor of development process, and their applicability.

Key words: hemodialysis, catheter-associated bloodstream infection, guideline, expert consensus, content analysis

中图分类号:

R459.5

陈青青, 曹小梅, 张祝君, 朱求丽, 陈晶梅. 血液透析导管相关血流感染预防指南及共识的质量评价和内容分析[J]. 护理学报, 2025, 32(5): 59-64.

CHEN Qingqing, CAO Xiaomei, ZHANG Zhujun, ZHU Qiuli, CHEN Jingmei. Quality evaluation and content analysis of guidelines and consensus on prevention of haemodialysis catheter-related bloodstream infections[J]. Journal of Nursing, 2025, 32(5): 59-64.

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