经桡动脉穿刺冠状动脉介入治疗术肢管理的最佳证据总结

目的 检索、评价及整合经桡动脉冠状动脉介入治疗术肢管理的最佳证据,为临床实践提供循证证据支持。 方法 应用循证方法,按照“6S”证据金字塔模型检索相关文献,检索时限为建库至2021年6月。由研究小组成员独立对各类文献进行质量评价,对符合标准的文献进行资料提取,并对各项证据进行分级判定。 结果 共纳入11篇文献,其中指南3篇,系统评价6篇,专家共识2篇。最终总结了21条经桡动脉冠状动脉介入治疗术肢管理的最佳证据,包括术前准备及评估、术后交接及观察、术后压迫与减压、活动时机与方式4个证据主题。 结论 该研究为经桡动脉冠状动脉介入治疗术肢管理提供了最佳证据,在证据转化时,应结合医院特点和临床情景,选择最佳证据,以改善桡动脉穿刺术肢围手术期的护理质量,提高患者的舒适度和安全性。

Evidence summary of limb management in transradial coronary intervention

Objective The best evidence on the limb management of transradial coronary intervention was retrieved,evaluated and integrated to provide evidence-based support for clinical practice. Methods By an evidence-based approach,the literature was searched according to the ‘6S’ pyramid of evidence model,with a timeframe of the database establishment to June 2021. Research team members independently evaluated the quality of the various types of the literature,extracted information that met the criteria,and graded each piece of evidence. Results A total of 11 papers were involved,including 3 guidelines,6 systematic reviews and 2 expert consensuses. The final summary of 21 pieces of best evidence on the management of the limb of transradial coronary intervention covers 4 topics,including preoperative preparation and assessment,postoperative handover and observation,postoperative compression and decompression,activity occasion and patterns. Conclusion This study provides the best evidence for the limb management of the transradial coronary intervention. When translating the evidence,the best evidence should be selected in relation to hospital characteristics and clinical scenarios,in order to improve the quality of perioperative care of the radial artery puncture limb and enhance the comfort and safety of patients.