| 郦杭婷，叶宝东，王丽娜，裘益玲，吴筱莲▲.血液病患者中心静脉通路装置相关性血流感染预防及处理的最佳证据总结[J].中国医药科学,2025,(2):104-108转158 基金项目:中华中医药学会血液系统疾病课题（202169-007） |
| 血液病患者中心静脉通路装置相关性血流感染预防及处理的最佳证据总结 |
| The best summary of evidence for prevention and treatment of central venous access device-related bloodstream infection in patients with hematological diseases |
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| DOI： |
| 中文关键词: 血液病；中心静脉通路装置；血流感染；证据总结；循证护理 |
| 英文关键词:Hematological diseases; Central venous access device; Bloodstream infection; Summary of evidence; Evidence-based nursing |
| 作者 | 单位 | | 郦杭婷，叶宝东，王丽娜，裘益玲，吴筱莲▲ | 浙江中医药大学附属第一医院 浙江省中医院血液内科，浙江杭州 310006 |
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| 中文摘要: |
| [摘要]目的 汇总血液病患者中心静脉通路装置相关性血流感染预防及处理的证据，为加强医护人员中心静脉通路装置相关性血流感染规范管理提供循证依据。方法 系统检索UpToDate、BMJ最佳临床实践、Joanna Briggs Institute循证卫生保健中心数据库、美国国立指南库、国际指南协作网、苏格兰校际指南网、英国国家卫生与临床优化研究所网站、加拿大安大略注册护士协会网站、美国静脉输液护理学会、医脉通指南网、PubMed、Web of Science、CINAHL、Cochrane Library、Embase、中国生物医学文献数据库、中国知网、万方、维普等数据库中关于血液病患者中心静脉通路装置相关性血流感染预防及处理的相关证据，检索时限为2013年1月至2023年9月，对纳入文献进行方法学质量评价，根据主题进行证据提取与汇总。结果 最终纳入18篇文献，其中临床决策1篇、指南3篇、系统评价14篇。证据包括评估与监测、置管与维护、导管更换与拔除、抗生素治疗、教育培训与质量管理5个方面，共40条证据。结论 医护人员需结合具体临床情境、证据的促进因素和阻碍因素及患者意愿，有针对性地选择最佳证据，降低血液病患者中心静脉通路装置相关性血流感染发生率，减少感染相关不良事件发生。 |
| 英文摘要: |
| [Abstract] Objective To summarize the evidence of prevention and treatment of central venous access device-related bloodstream infection in patients with hematological diseases, and provide evidence-based foundation for strengthening the standardized management of central venous access device-related bloodstream infection in medical staff. Methods Relevant evidence about the prevention and treatment of central venous access device-related bloodstream infection in patients with hematological diseases were systematically searched in databases such as UpToDate, BMJ Best Clinical Practice, Joanna Briggs Institute Evidence-based Health Care Center Database, National Guideline Clearinghouse, Guidelines International Network, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence website, Registered Nurses’ Association of Ontario website, American Infusion Nurses Society, Medlive Network, PubMed, Web of Science, CINAHL, Cochrane Library, Embase, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang, VIP, etc. The retrieval time is from January 2013 to September 2023. The methodological quality of the included literature is evaluated, and the evidence is extracted and summarized according to the theme. Results Finally, a total of 18 articles were included, covering 1 article about clinical decision, 3 articles about guidelines and 14 articles about systematic reviews. The evidence includes 40 pieces of evidence in 5 aspects: evaluation and monitoring, catheter placement and maintenance, catheter replacement and removal, antibiotic treatment, education and training and quality management. Conclusion Medical staff should choose the best evidence according to the specific clinical situation, the promoting factors, hindering factors and patients’ wishes, so as to reduce the incidence of central venous access device-related bloodstream infection in patients with hematological diseases and reduce infection-related adverse events. |
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