| 王雨晴,胡静,沈静丽,顾莺,杨玉霞,金芸,闫钢风,应佳云,秦杨.危重患者连续血液净化体外循环管路凝血相关指标血标本采集的证据总结[J].上海护理,2026,26(7): |
| 危重患者连续血液净化体外循环管路凝血相关指标血标本采集的证据总结 |
| Evidence Summary for blood sample collection of coagulation-related indicators in extracorporeal circulation lines for continuous blood purification in critically ill patients |
| DOI： |
| 中文关键词: 重症监护病房 连续血液净化 管路采血 凝血功能 循证护理学 |
| 英文关键词:Intensive Care Units Continuous Blood Purification Catheter Blood Collection Coagulation Function Evidence-Based Nursing |
| 基金项目:2023年度上海市级医院诊疗技术推广及优化管理项目（SHDC22023240)；复旦大学循证护理中心证据转化与临床应用项目（Fudanebn202530） |
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| 中文摘要: |
| 目的：检索、评价并整合危重患者连续血液净化体外循环管路凝血相关指标血标本采集的相关证据。方法：计算机检索UpToDate临床顾问、BMJ最佳临床实践、JBI图书馆、Cochrane图书馆、Campbell合作网及各指南网站中关于危重患者连续血液净化体外循环管路血标本采集相关的临床决策、推荐实践、证据总结、专家共识、系统评价、meta分析，进行方法学质量评价后，根据主题对证据进行提取与汇总。结果：根据纳入标准筛选出证据7篇，包括专家共识5篇、证据总结1篇、meta分析1篇。通过阅读、提取和归类，最终总结了监测指标、采血部位、采血时机、机器调节4个证据大类的12条证据。结论：重症监护室医务人员应遵循最佳证据，及时规范的进行体外循环管路血标本采集以监测患者凝血功能，从而降低危重患者连续血液净化非计划下机的发生率，并为制定连续血液净化体外循环管路血标本采集规范化流程提供依据。 |
| 英文摘要: |
| Objective To retrieve, evaluate, and integrate the relevant evidence for blood sample collection of coagulation-related indicators in extracorporeal circulation circuits during continuous blood purification in critically ill patients. Methods: A computerized search was conducted in UpToDate Clinical Advisor, BMJ Best Practice, JBI Library, Cochrane Library, Campbell Collaboration, and various guideline websites for clinical decision-making, recommended practices, evidence summaries, expert consensus, systematic reviews, and meta-analyses related to blood sample collection from extracorporeal circulation circuits during continuous blood purification in critically ill patients. After evaluating the methodological quality of the evidence, it was extracted and summarized according to the theme. Results: Seven pieces of evidence were identified based on the inclusion criteria, including five expert consensus statements, one evidence summary, and one meta-analysis. After reading, extracting, and categorizing the evidence, 12 pieces of evidence were summarized across four major categories: monitoring indicators, blood collection sites, blood collection timing, and machine adjustments. Conclusion: ICU healthcare providers should follow the best available evidence to promptly and appropriately collect blood samples from extracorporeal circulation lines to monitor patients'' coagulation function, thereby reducing the incidence of unplanned shutdown of continuous blood purification in critically ill patients and providing a basis for establishing standardized procedures for blood sample collection from extracorporeal circulation lines during continuous blood purification. |
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