摘要
目的检索、评价和汇总新生儿经外周静脉置入中心静脉导管(PICC)超声引导置管及尖端定位的最佳证据。方法根据"6S"证据金字塔模型,依次检索各指南网站、专业协会网站和期刊数据库中新生儿PICC超声引导置管及尖端定位相关的文献,检索时限均为建库至2024年9月30日。由2名研究者采用统一的标准对文献进行独立质量评价和证据提取,对提取的证据进行整合、汇总。结果共纳入10篇文献,其中指南5篇、临床决策1篇、专家共识2篇、Meta分析1篇、证据总结1篇,从人员资质及培训、导管选择、置管静脉评估、超声引导新生儿PICC穿刺、新生儿PICC尖端定位和异位的预防及处理6个方面形成了30条证据。结论本研究总结了新生儿PICC超声引导置管及尖端定位的最佳证据,建议结合科室资源环境和医护人员技能水平选择并应用证据,制订新生儿PICC置管标准化流程,提高护理质量,确保PICC在临床中的安全和有效使用。
ObjectiveTo retrieve,evaluate,and summarize the best evidence on ultrasound-guided placement and tip confirmation of peripherally inserted central catheter(PICC)in neonates.MethodsBased on the"6S"evidence pyramid model,literature on ultrasound-guided placement and tip confirmation of PICC in neonates was sequentially searched on guideline websites,professional society websites,and journal databases.The search period was from database establishment to September 30,2024.Two researchers used uniform criteria for independent quality assessment and evidence extraction from the literature,and the extracted evidence was integrated and summarized.ResultsA total of ten articles were included,including five guidelines,one clinical decision,two expert consensus,one Meta-analysis,and one evidence summary.Thirty pieces of evidence were developed in six aspects:personnel qualification and training,catheter selection,assessment of placement veins,ultrasound-guided PICC puncture in neonates,PICC tip confirmation in neonates,and prevention and management of malposition.ConclusionsThis study summarizes the best evidence for ultrasound-guided placement and tip confirmation of PICC in neonates.It is recommended that evidence be selected and applied to develop a standardized process for neonatal PICC placement in conjunction with the resource environment of the department and the skill level of the healthcare professionals to improve the quality of nursing and to ensure the safe and effective use of the PICC in clinical practice.
作者
谢晨鹏
舒琳
郭曼洁
何利
常婧妤
吴小霞
Xie Chenpeng;Shu Lin;Guo Manjie;He Li;Chang Jingyu;Wu Xiaoxia(Nursing Department,the Third Xiangya Hospital of Central South University,Changsha 410013,China;Xiangya School of Nursing,Central South University,Changsha 410031,China;Nursing Department,the First People's Hospital of Yunnan Province,Kunming 650032,China;Department of Neonatology,the Third Xiangya Hospital of Central South University,Changsha 410013,China)
出处
《中华现代护理杂志》
2025年第17期2262-2269,共8页
Chinese Journal of Modern Nursing
基金
湖南省自然科学基金(2020JJ4829)。
