植入式静脉输液港相关性感染预防及管理的最佳证据总结
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女,硕士,主管护师

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Evidence summary for prevention and management of implantable venous access port-related infection
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    摘要:

    目的 检索评价并总结植入式静脉输液港相关性感染预防及管理的最佳证据。方法 计算机检索英国国家医疗保健优化研究所、加拿大安大略注册护士协会、美国静脉输液护士协会、BMJ最佳临床实践、Cochrane Library、JBI循证卫生保健国际合作中心图书馆、美国国立生物技术信息中心、PubMed、中国临床指南网、中国知网、万方、维普数据库和中国生物医学数据库关于植入式静脉输液港相关性感染预防及管理的所有证据,包括指南、最佳实践信息册、推荐实践、系统评价及专家共识。结果 共纳入文献7篇,其中指南5篇,系统评价1篇,专家共识1篇。汇总后的证据包括感染危险因素/人群、质量管理、置管方式和位置、导管装置管理、感染预防和控制、拔除导管时机6个方面,共计22条证据内容。结论 医护人员应对植入静脉输液港患者进行动态的感染危险因素评估。同时,应根据患者实际情况选择合适的置管位置和方式、加强质量管理及导管装置管理、规范感染预防的处理策略,以降低输液港相关性感染的发生率。

    Abstract:

    Objective To retrieve, appraise and summarize the best evidence on prevention and management of implantable venous access port-related infection. Methods Such websites or databases as the National Institute for Health and Care Excellence (NICE), the Registered Nurses′ Association of Ontario (RNAO), the Infusion Nurses Society (INS) ,BMJ Best Practice,Cochrane Library,Joanna Briggs Institute Library, the National Center for Biotechnology Information (NCBI),PubMed,China Guideline Clearinghouse (CGC),CNKI,Wangfang Data, VIP database and Chinese Biomedical Literature Database (CBM) were searched to collect literatures including guidelines,best practice information sheet,recommended practices,systematic reviews,and expert consensus statements. Results A total of 7 publications were recruited,including five guidelines,one systematic review and one expert consensus statement and totally 22 items of best evidence, which could be grouped into six categories(risk factors/populations, quality management, placement methods and locations of access ports, port device management, prevention and control of infection, timing of port removal) were summarized. Conclusion Medical staff should dynamically assess the risk factors of infection in patients with implantable venous access port. Meanwhile, it is necessary to select the appropriate placement methods and locations of access ports to fit patients′ conditions, strengthen the quality management and port device management, and standardize the treatment strategy of infection prevention, so as to reduce the incidence rate of port-related infection.

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谢琼,卢咏梅,方少梅,阮小丽.植入式静脉输液港相关性感染预防及管理的最佳证据总结[J].护理学杂志,2020,35(12):49-53

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  • 收稿日期:2020-01-17
  • 最后修改日期:2020-03-02
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  • 在线发布日期: 2022-09-06