■由于不成熟,早产儿的鼻子很容易受伤,即使是短暂的鼻腔装置的应用。然而,20%至60%的早产儿由于皮肤组织薄弱而使用鼻持续气道正压通气(NCPAP)时遭受鼻损伤,长时间使用鼻装置,和不当的护理实践,导致感染风险增加,依从性和耐受性下降。在这项研究中,我们找到了,获取并整合了早产儿鼻腔无创通气预防鼻部损伤的相关证据,为临床提供参考。
■我们搜索了相关指南,专家共识,国家健康与护理卓越研究所(NICE)的数据库和指南网站中的证据摘要和系统综述,苏格兰校际指南网络(SIGN),医疗保健研究和质量机构(AHRQ),准则国际网络(GIN),世界卫生组织(WHO)指南网站,安大略省注册护士协会(RANO),妇女健康协会,产科和新生儿护士(AWHONN),欧洲压力性溃疡咨询小组(EPUAP),易麦通,英国医学杂志最佳实践,科克伦图书馆,UpToDate,Embase,PubMed,中国国家知识基础设施(CNKI),万方。搜索仅限于图书馆建立时间至2023年2月。
■总共,包括16篇文章,包括六个准则,三个专家共识,两个证据摘要和五个系统评价。从六个方面总结了28条证据:风险评估、通风和连接,皮肤保护,皮肤评估,培训和支持,和持续的质量改进。
■本研究总结了通过鼻腔无创通气预防早产儿鼻腔损伤的最佳证据。建议护士在应用证据建议时应考虑临床实际情况,制定相应的护理措施,减少早产儿鼻腔损伤的发生。
UNASSIGNED: Due to immaturity, the nose of preterm infants can easily be injured, by even a short application of a nasal device. However, 20% to 60% of preterm infants suffer nasal damage while using nasal continuous positive airway pressure (NCPAP) due to weak skin tissue, prolonged use of nasal device, and improper nursing practices, leading to increased risk of infection and decreased compliance and tolerance. In this study, we retrieved, obtained and integrated the related evidences of prevention of nasal injury in premature infants with nasal noninvasive ventilation to provide reference for clinical practice.
UNASSIGNED: We searched the relevant guidelines, expert consensus, evidence summaries and systematic reviews in the databases and guideline websites of the National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), the Agency for Health care Research and Quality (AHRQ), Guidelines International Network (GIN), the World Health Organization (WHO) guideline websites, Registered Nurses\' Association of Ontario (RANO), Association of Women\'s Health, Obstetric and Neonatal Nurses (AWHONN), European Pressure Ulcer Advisory Panel (EPUAP), Yi Maitong, British Medical Journal best-practice, Cochrane Library, UpToDate, Embase, PubMed,
China National Knowledge Infrastructure (CNKI), Wanfang. The search was limited to the time of library establishment to February 2023.
UNASSIGNED: In total, 16 articles were included, including six guidelines, three expert consensuses, two evidence summaries and five systematic reviews. Twenty-eight pieces of evidence were summarized from six aspects: risk assessment, ventilation and connection, skin protection, skin assessment, training and support, and continuous quality improvement.
UNASSIGNED: This study summarized the best evidence for the prevention of nasal injury in premature infants through nasal noninvasive ventilation. It is suggested that nurses should consider the actual clinical situation when applying the suggestions from the evidence, formulate corresponding nursing measures, and reduce the occurrence of nasal injury in premature infants.