摘要目的? 总结内科危重症住院患者DVT预防的最佳证据,为医疗机构及医护人员提供参考,以降低危重症患者DVT的发生率.方法? 针对内科危重症患者住院期间DVT预防提出PICO问题,计算机检索PubMed、Cochran Library、BMJ Best Practice、UpToDate、Ovid、Web of Science、Joanna Briggs Institute循证卫生保健中心数据库、美国指南网、英国国家临床医学研究所、苏格兰院际指南网、国际指南协作网、安大略注册护士协会和中国生物医学文献数据库等关于内科危重症住院患者DVT预防的所有证据,包括指南、系统评价、证据总结及与证据密切相关的原始数据,并进行文献质量评价,根据JBI证据推荐级别系统(2014版)确定证据的推荐级别.结果? 通过电子数据库检索共纳入文献15篇,包括指南6篇、证据总结5篇、系统评价4篇.共总结出内科急危重症患者DVT预防的证据21条,包括DVT风险的评估、药物预防、机械预防、联合预防及教育管理等.结论? 本研究总结了目前关于内科危重症患者DVT预防的最佳证据,可为临床提供可参考的循证依据.通过最佳证据的应用,以促进内科急危重患者DVT的预防,改善患者结局,提高护理质量.

abstractsObjective To summarize the best evidence for the prevention of deep venous thrombosis (DVT) in critically ill patients, and to provide a reference for medical institutions and medical staff, so as to reduce the incidence of DVT in critically ill patients. MethodsThe PICO problem was raised for the prevention of DVT in critically ill patients during hospitalization. All evidence concerning the prevention of deep venous thrombosis in critically ill patients were retrieved from PubMed, Cochran Library, BMJ Best Practice, UpToDate,Ovid,Web of Science,Joanna Briggs Institute Evidence-based Health Care Center Database, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Registered Nurses' Association of Ontario (RNAO) and China Biology Medicine disc (CBMdisc) by computer, which included guidelines, systematic evaluation, evidence summary and original data intimately related to evidence. The literature quality was evaluated and the recommendation level of evidence was determined according to the JBI evidence recommendation level system (2014 edition). ResultsA total of 15 references were included through electronic database retrieval, including 6 guidelines, 5 evidence summaries and 4 systematic evaluations. According to the judgment of comprehensive professionals, totally 21 evidence selected,including the risk assessment of deep venous thrombosis, drug prevention, mechanical prevention, combined prevention and educational management. ConclusionsThis study summarizes the best evidence for the prevention of DVT in critically ill patients, and helps nurses with ICU decision-making, through the application of best evidence, to promote the prevention of deep venous thrombosis in critical internal medicine patients, improve the outcome of patients and elevate the quality of nursing care.