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中华重症医学电子杂志 ›› 2023, Vol. 09 ›› Issue (02) : 97 -115. doi: 10.3877/cma.j.issn.2096-1537.2023.02.001

所属专题: 总编推荐 指南共识

专家共识

中国成人重症患者镇痛管理专家共识
中华医学会重症医学分会重症呼吸学组, 中国临床实践指南联盟   
  • 收稿日期:2023-03-13 出版日期:2023-05-28

Expert consensus on analgesic management in severe adult patients in China

Subgroup of Critical Respiratory Diseases, China Clinical Practice Guideline Alliance   

  • Received:2023-03-13 Published:2023-05-28
引用本文:

中华医学会重症医学分会重症呼吸学组, 中国临床实践指南联盟. 中国成人重症患者镇痛管理专家共识[J]. 中华重症医学电子杂志, 2023, 09(02): 97-115.

Subgroup of Critical Respiratory Diseases, China Clinical Practice Guideline Alliance. Expert consensus on analgesic management in severe adult patients in China[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2023, 09(02): 97-115.

表1 重症患者常用阿片类镇痛药物特点
表2 文献的证据等级(牛津循证医学中心2011版)
(临床)问题 步骤1 步骤2 步骤3 步骤4 步骤5
(等级1* (等级2* (等级3* (等级4* (等级5*
这个疾病有多普遍?(患病率) 当地的,当前的随机样本调查(或普查) 与当地情况相匹配调查的系统评价** 当地的,非随机样本调查** 病例系列** N/A
诊断或监测实验是否准确(诊断) 一致地应用了参考标准和盲法的横断面研究的系统评价 一致地应用了参考标准和盲法的横断面研究 非连续病例研究,或研究未能一致地应用参考标准** 病例对照研究,或应用了差的或非独立的参考标准** 基于机制的推理
若不给予这个治疗会发生什么?(预后) 起始队列研究的系统评价 起始队列研究 队列研究或随机研究的对照组* 病例系列或病例对照研究,或低质量预后队列研究** N/A
这个治疗有用吗?(治疗效益) 随机试验或单病例随机对照试验的系统评价 随机试验或具有巨大效果的观察性研究 非随机对照队列/随访研究** 病例系列,病例对照研究,或历史对照研究** 基于机制的推理
这个治疗常见的伤害是什么(治疗伤害) 随机试验的系统评价,巢式病例对照研究的系统评价,针对你所提临床问题患者的n-of-1试验,具有巨大效果的观察性研究 单个随机试验或(特殊的)具有巨大效果的观察性研究 非随机对照队列/随访研究(上市后监测)提供,足够数量来排除常见的伤害(对长期伤害需要足够长的随访时间)** 病例系列,病例对照研究,或历史对照研究** 基于机制的推理
这个治疗少见的伤害是什么?(治疗伤害) 随机试验或n-of-1试验的系统评价 随机试验或(特殊的)具有巨大效果的观察性研究
这个实验(早期发现)值得吗?(筛查) 随机研究的系统评价 随机试验 非随机对照队列/随访研究* 病例系列,病例对照研究,或历史对照研究** 基于机制的推理
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