目的 系统检索、评价并提炼出维持性血液透析(maintenance hemodialysis,MHD)患者带隧道带涤纶套导管(tunnel-cuffed catheter,TCC)护理的最佳证据，为构建科学的血液透析导管护理管理规范提供循证依据。方法 采用循证研究方法，系统检索国内外数据库资料，由2名循证研究人员独立进行文献质量评价，纳入文献通过专家会议法进行证据提取、分类和整合最终形成最佳证据。结果 共纳入文献15篇，包括系统评价1篇、指南7篇、专家共识6篇、证据总结1篇。总结出评估与监测、冲管与封管、消毒与换药、并发症管理及质量改进5个主题，共提炼出31条最佳证据。结论 本研究提炼分析了MHD患者TCC护理相关的最佳证据，为有效预防TCC相关并发症的发生、延长血管通路使用寿命、进一步提高血液透析护理管理质量提供了科学循证依据。

Objective To systematically retrieve,evaluate and extract the best evidence of maintenance hemodialysis(MHD) patients with tunnel-cuffed catheter (TCC) and provide best evidence for the construction of a scientific nursing management standard of hemodialysis catheter.Methods Evidence-based research techniques were used to systematically search data from domestic and foreign databases,and 2 evidence-based researchers independently evaluated the literature.The best evidence was finally obtained from the papers with the expert discussion method.Results A total of 15 papers were included: 1 systematic review,7 guidelines,6 expert consensus and 1 evidence summary. 5 themes (evaluation and monitoring,flushing and sealing,disinfection and dressing change,complication management, and quality improvement) were summarized,while 31 pieces of best evidence were extracted.Conclusions This study not only extracts and analyzes the best evidence related to TCC nursing in MHD patients,provides scientific and evidence-based basis for effectively prevention of the occurrence of TCC-related complications,but also prolongs the service life of vascular access,and further improves the quality of hemodialysis nursing management.

R459.5

海军军医大学深蓝护理科研项目(2022KYG14)；复旦大学循证护理中心证据转化与临床应用项目(Fudanebn 202334)