成人住院患者鼻胃管非计划拔管预防策略的最佳证据总结 [中文引用][英文引用]

目的  检索、评价并整合成人住院患者鼻胃管非计划拔管预防策略的相关证据，为临床安全、有效管理提供科学依据。方法  系统检索 BMJ Best Practice，UpToDate，乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健国际合作中心图书馆，医脉通，美国国立指南数据库，国际指南协作组，苏格兰学院际指南网，加拿大安大略注册护士协会，英国国家临床优化研究所，新西兰指南研究组，PubMed，EMbase，Cochrane Library，Web of Science，EBSCO，CINAHL，中国知网，SinoMed，万方，维普数据库。检索时间为建库至 2024 年 8 月 1 日。由 2 名具有循证基础的研究者对纳入指南、临床决策、推荐实践、证据总结、专家共识以及系统评价进行方法学质量评价后，对符合纳入标准的文献进行资料提取和证据总结。结果  最终纳入15 篇文献，其中指南 2 篇，临床决策 1 篇，推荐实践 3 篇，证据总结 7 篇，系统评价 2 篇。总结出最佳证据 30 条，包括置管前风险评估、鼻胃管选用、置管深度、固定、位置确认、管理、健康教育共 7 个主题。结论  建议证据应用者需结合临床实际选择最佳证据，对成人住院患者鼻胃管非计划拔管进行风险因素评估和管理，为患者提供个性化针对性的干预方案，以减少或避免成人住院患者鼻胃管非计划拔管发生。

Objective To search，evaluate and synthesise the best available evidence on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients and to offer a reference in management of safety and efficiency. Methods Literature on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients was retrieved across BMJ Best Practice， UpToDate，JBI Center for Evidence Based Healthcare International Collaboration Library，Medlive，US National Guidelines Database， International Guidelines Collaboration Group，Scottish InterAcademy Guidelines Network，Ontario Registered Nurses Association of Canada，UK National Institute for Clinical Optimization，New Zealand Guidelines Research Group，PubMed，EMbase，Cochrane Library， Web of Science，EBSCO，CINAHL，CNKI，CBM Database，Wanfang Data and VIP Database，from the inception of databases to August 2024. Retrieved literature included guidelines，clinical decisions，recommended practices，evidence summaries，expert consensus and systematic reviews. Two researchers evaluated the literature methodologically and then summarised evidence from the included data. Results Fifteen publications（2 guidelines，1 clinical decision，3 recommended practices，7 evidences and 2 systematic reviews）were included. A total of 30 pieces of evidence were extracted and they were grouped into 7 themes：risk assessment，selection of nasogastric tube，depth of intubation，tube fixation，tube position，tube management and patient education. Conclusion Clinicians should integrate the best evidences into clinical practice and assess risk factors for unplanned extubation of nasogastric tube in adult inpatients. Personalised early intervention plans should be made to reduce or avoid the unplanned extubation.