Evidence summary of best practice on the management of dysphagia in patients with idiopathic inflammatory myopathy
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目的 评价、总结特发性炎性肌病(idiopathic inflammatory myopathy,ⅡM)患者吞咽障碍管理的最佳实践证据,为其科学化管理提供依据.方法 系统检索Up To Date、美国国立指南网、英国国家医疗保健优化研究所等相关指南网,欧洲吞咽障碍学会、欧洲抗风湿病联盟、美国风湿病学会各专业协会网站和PubMed、Cochrane Li-brary等数据库关于ⅡM患者吞咽障碍的临床决策指南、专家共识、证据总结和系统评价,检索时限为建库至2022年4月20日.由2名研究者独立完成文献质量评价和内容提取,依据证据预分级系统确定证据等级.结果 共纳入20篇文献,包括1篇临床决策、5篇指南、4篇系统评价、9篇专家共识和1篇证据总结,最终形成最佳证据20条,包括多学科团队、吞咽障碍筛查与评估、药物干预等8个主题.结论 吞咽障碍的早期筛查与评估对ⅡM患者疾病管理至关重要,医护人员应选择适宜的工具对ⅡM患者进行吞咽功能常规筛查,以及时识别和干预吞咽困难,减少患者营养不良及吸入性肺炎等并发症的发生率.
Objective To evaluate and summarize the best practice evidence of the management of dysphagia in pa-tients with idiopathic inflammatory myopathy(ⅡM),and provide basis for its scientific management of dysphagia.Methods The clinical decisions,guidelines,expert consensus,evidence summary,and system evaluation of the ⅡM patients'dysphagia in Up To Date,National Guideline Clearinghouse,National Institute for Health and Clinical Ex-cellence and other guideline websites,and European Society for Swallowing Disorders,The European League A-gainst Rheumatism,and American College of Rheumatology websites,PubMed,Cochrane Library,and other data-bases were systematically searched,and the retrieval time was from the establishment of the database to April 20,2022.Literature quality evaluation and content extraction were carried out by 2 researchers,and the evidence grade was determined according to the evidence pre-grading system.Results A total of 20 articles were included,including 1 clinical decisions,5 guidelines,4 systematic review,9 specialized consensus,and 1 evidence summary,and 20 pieces of best evidences were finally formed,including 8 topics which were multidisciplinary team,dysphagia screen-ing and assessment,drug intervention,etc.Conclusion Early screening and evaluation of dysphagia in patients withⅡM is critical to disease management.Healthcare professionals should choose appropriate tools to routinely screen patients with ⅡM for swallowing function,so as to identify and intervene in dysphagia in a timely manner,and re-duce the incidence of complications such as malnutrition and aspiration pneumonia.
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