【摘要】 目的通过证据检索,将深静脉血栓(Deep Vein Thrombosis,DVT)预防策略的最佳证据应用于成人重症监护室临床,从而降低危重症患者DVT发生率。方法对相关主题进行系统检索及文献质量评价,从DVT评估、基础预防、物理预防、药物预防四方面总结最佳证据,并结合临床情景和专业判断及患者、家属意愿,构建基于证据的质量指标,制定本土化的DVT循证实践方案,排除障碍因素,应用于临床,并对比证据应用前后的质量指标。结果证据应用前后DVT发生率分别1.1%(5/468)和0(0/582),ICU住院天数为(8.8±2.08)日和(7.6±1.80)日,护士满意度分别为86%和96%,各项审查指标较前改善(P <0.05),并形成防范危重患者DVT风险的标准评估及实施流程。结论基于临床证据的DVT预防策略在成人ICU的应用,使预防措施更具针对性,提高护理人员的效率,减低危重患者DVT发生率,减少ICU患者并发症,有利于改善患者结局。更多还原

【Abstract】 Objective The best evidence of DVT prevention strategy in adult ICU was carried out in clinical work by evidence searching,in order to decrease the incidence rate of DVT in critically ill patients.Methods The articles were investigated and evaluated according to the medical subject headings( MeSH).The best evidence was concluded in terms of the DVT evaluation,basic prevention,physical prevention and drug prevention.The quality indications were constructed based on the evidence,combined with the clinical situation,professional judgement and the will of patients and their family.Then a plan of local DVT evidence-based practice was made and applied to the clinical work,excluding the obstacle factors.Results Before and after the application of the evidence,the incidence of DVT was 1.1%( 5 ax 468) and 0( 0 ram 582)( P < 0.05).The ICU hospital stay was( 8.8 ± 2.08) days and( 7.6 ± 1.80) days( P < 0.05),the satisfaction of nurses increased from 86% to 96%,the examination indicators were improved,and formed a standard evaluation and implementation process to prevent the risk of DVT in critically ill patients.Conclusion The application of the DVT prevention strategy in adult ICU based on the clinical evidence,can improve the pertinence of the prevention measures,raise the working efficiency of the nurses,decrease the incidence rate of DVT,reduce the complications of the patients and was beneficial to improve the clinical outcome of the patients.更多还原