摘要
目的 评价总结国内外脑卒中患者吞咽障碍管理的最佳证据.方法 系统检索英国国家临床医学研究所、美国心脏协会/美国脑卒中协会、加拿大临床实践指南网、Cochrane library、Ovid-JBI、PubMed、CINAHL、万方、中国知网等专业网站或数据库内关于脑卒中患者吞咽障碍管理的相关证据,包括临床实践指南、系统评价、证据总结和专家共识.检索时限从建库至2022年8月31日.结果 共纳入32篇文献.其中指南4篇,系统评价25篇,证据总结2篇,专家共识1篇.对纳入的文献进行证据总结,共归纳出吞咽障碍筛查、吞咽功能评估、康复治疗、营养支持、口腔卫生、教育培训6类共28条证据.结论 本研究总结了脑卒中患者吞咽障碍管理的最佳证据,在临床实践中应根据相应的临床情境、患者偏好等因素筛选出适合的证据,从而为脑卒中患者制定个性化的吞咽障碍管理方案,以达到提升护理质量,改善患者结局的目的.
Abstract
Objective To evaluate and summarize the best evidence for the management of dysphagia in stroke pa-tients both domestically and internationally.Methods A systematic search was conducted in professional websites or databases including the National Institute for Health and Care Excellence(NICE),the American Heart Association/American Stroke Association,the Canadian Clinical Practice Guidelines,Cochrane library,Ovid-JBI,PubMed,CI-NAHL,Wanfang,CNKI,etc.,for relevant evidence on the management of dysphagia in stroke patients,including clinical practice guidelines,systematic reviews,evidence summaries,and expert consensus.The search was conduc-ted from the establishment of the database until August 31,2022.Results A total of 32 articles were included,com-prising 4 guidelines,25 systematic reviews,2 evidence summaries,and 1 expert consensus.Evidence synthesis of the included literature yielded 28 pieces of evidence categorized into 6 types:Screening for dysphagia,assessment of swallowing function,rehabilitation therapy,nutritional support,oral hygiene,and educationtraining.Conclusion This study summarizes the best evidence for the management of dysphagia in stroke patients,and in clinical practice,evidence suitable should be selected based on corresponding clinical contexts,patient preferences,etc.,so as to de-velop personalized dysphagia management plans for stroke patients,thereby improving nursing quality and patient outcomes.
基金项目
复旦大学附属中山医院重点薄弱学科建设基金(XK-082-004)
维普
万方数据