成人PICC/上臂输液港原发性导管异位管理的最佳证据总结

doi:10.3761/j.issn.1672-9234.2024.05.017

摘要/Abstract

摘要：

目的评价、总结国内外成人PICC/上臂输液港原发性导管异位管理的最佳证据，为临床医护人员识别、预防和处理成人PICC/上臂输液港原发性导管异位提供参考。方法系统检索中英文数据库、指南相关网站和专业学会网站中有关成人PICC/上臂输液港原发性导管异位管理的证据，包括临床决策、最佳实践、临床实践指南、系统评价、证据总结和专家共识。检索时限为建库至2023年12月31日。2名研究者独立对纳入文献进行质量评价，并结合专业判断进行标准化的资料提取和证据分级。结果该研究共纳入13篇文献，包括6篇临床实践指南、2篇证据总结和5篇专家共识。最终从识别、预防及处理3个方面总结了39条最佳证据。结论该研究为临床医护人员管理成人PICC/上臂输液港原发性导管异位提供循证依据。在临床应用时，需要充分考虑临床情景，结合专业人士的判断及患者的意愿，遵循个体化原则，审慎地将证据应用于临床实践中。

关键词: 中心静脉导管, 导管插入术, 循证护理学, 证据总结

Abstract:

Objective To evaluate and summarize the best evidence on the management of primary malposition in adult patients with PICC/arm port，and to provide a reference for clinical staff to identify，prevent and treat primary malposition in adult PICC/arm port. Methods The evidence on management of primary malposition in adult PICC/arm port from international guideline websites，websites of academic societies or institutions，and electronic databases were systematically searched. The retrieved evidence included clinical decision-making，best practice，guidelines，systematic reviews，evidence summaries and expert consensuses. The search time limit was set from inception to December 31st，2023. After that，two researchers evaluated the quality of the literature and extracted the data. Results A total of 13 articles were included in this study，including six clinical practice guidelines，two evidence summaries and five expert consensuses. Finally，39 recommendations were summarized in three aspects of identification，prevention and treatment. Conclusion This study provides an evidence-based basis for clinical staff to manage primary malposition in adult PICC/arm port. It is suggested that clinical staff should fully consider the clinical situation，combine professional judgment and patient wishes，follow the principle of individualization and apply the evidence to clinical practice prudently.

Key words: Central Venous Catheter, Catheterization, Evidence-Based Nursing, Evidence Summary

朱松颖, 谭然, 高蔚. 成人PICC/上臂输液港原发性导管异位管理的最佳证据总结[J]. 中华护理教育, 2024, 21(5): 613-619.

ZHU Songying, TAN Ran, GAO Wei. The best evidence summary on management of primary malposition in adult patients with peripherally inserted central catheter/arm port[J]. Chinese Journal of Nursing Education, 2024, 21(5): 613-619.

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