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急性主动脉夹层紧急目标血压管理的循证综述

An Evidenced-Based Review of Emergency Target Blood Pressure Management for Acute Aortic Dissection.

作者信息

Hu Hankui, Wu Zhoupeng

机构信息

Department of Vascular Surgery, West China Hospital, 37 Guoxue Alley, Chengdu 610041, Sichuan, China.

出版信息

Emerg Med Int. 2023 Jul 20;2023:8392732. doi: 10.1155/2023/8392732. eCollection 2023.

Abstract

OBJECTIVE

To summarize the best evidence of emergency target blood pressure management for acute aortic dissection and provide guidance for evidence-based practice of emergency target blood pressure management.

METHODS

According to the "6S" evidence pyramid model, the evidence of emergency target blood pressure management of acute aortic dissection in various foreign databases and websites of professional associations from January 1, 2010, to August 1, 2022, was retrieved, including clinical decision-making, guidelines, expert consensus, systematic reviews, randomized controlled trials, cohort studies, and case series. Two researchers used the corresponding document quality evaluation tools to evaluate the documents and extracted and summarized the evidence of documents above grade B.

RESULTS

A total of 17 articles were included, including 6 clinical decision-making articles, 5 guidelines, 2 expert consensus articles, 1 systematic review article, 1 randomized controlled trial article, 1 cohort study article, and 1 case series article, forming 36 best evidences, including 9 topics, which are target value setting, management strategy, disease observation, medical history collection, monitoring methods, vasoactive drugs, nonvasoactive drugs, related examinations, and patient education.

CONCLUSION

The best evidence summarized provides a reference for doctors and nurses in the emergency department to manage the emergency target blood pressure of patients with acute aortic dissection. It is recommended that doctors and nurses in the emergency department follow the best evidence summarized to develop individualized target blood pressure management plan for patients.

摘要

目的

总结急性主动脉夹层急诊目标血压管理的最佳证据,为急诊目标血压管理的循证实践提供指导。

方法

依据“6S”证据金字塔模型,检索2010年1月1日至2022年8月1日期间国外各数据库及专业协会网站中有关急性主动脉夹层急诊目标血压管理的证据,包括临床决策、指南、专家共识、系统评价、随机对照试验、队列研究和病例系列。两名研究人员使用相应的文献质量评价工具对文献进行评价,提取并总结B级以上文献的证据。

结果

共纳入17篇文章,其中临床决策文章6篇、指南5篇、专家共识文章2篇、系统评价文章1篇、随机对照试验文章1篇、队列研究文章1篇、病例系列文章1篇,形成36条最佳证据,涵盖9个主题,即目标值设定、管理策略、病情观察、病史采集、监测方法、血管活性药物、非血管活性药物、相关检查和患者教育。

结论

总结的最佳证据为急诊科医生和护士管理急性主动脉夹层患者的急诊目标血压提供参考。建议急诊科医生和护士遵循总结的最佳证据,为患者制定个体化的目标血压管理方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a7b/10374381/7ee6f9c7c410/EMI2023-8392732.001.jpg

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