摘要
目的 评价并整合胆汁淤积患者皮肤瘙痒管理的相关证据,为胆汁淤积所致皮肤瘙痒患者的临床护理实践提供参考依据.方法 针对胆汁淤积患者皮肤瘙痒问题,进行国内外证据检索,包括临床决策、指南、专家共识、证据总结、系统评价.2名具有循证医学专业背景的研究者对文献质量进行独立评价和证据级别评定,并提取相关证据.结果 共纳入文献 18篇,包括 4篇临床决策、2 篇指南、2 篇证据总结、6 篇系统评价和 4篇专家共识,总结归纳出瘙痒评估、瘙痒病因处理、皮肤护理、局部治疗、全身用药、手术治疗、辅助治疗、心理护理 8 个方面,共 23条最佳证据,形成了胆汁淤积患者皮肤瘙痒管理方案.结论 医护人员在临床实践中可结合目前最佳证据和患者价值观,制定个性化的治疗计划,以提高患者生活质量.
Abstract
Objective To evaluate and summarize the best evidence for the management of pruritus in patients with cholestasis,and to provide reference for clinical nursing practice in the treatment of pruritus caused by cholestasis.Methods An evidence-based nursing approach and the"5S"evidence model were employed to search for relevant evidence on the management of pruritus in cholestatic patients,including clinical decision-making,guidelines,expert consensus,evidence summaries,and systematic reviews from both domestic and international sources.Two researchers with background in evidence-based medicine independently assessed the quality of the literature and rated the evidence level,extracting the evidence meeting the criteria.Results A total of 18 articles were collected,including 4 clinical decision-makings,2 guidelines,2 evidence summaries,6 systematic reviews,and 4 expert consensuses.Twenty-three pieces of best evidence were summarized into eight areas:pruritus assessment,management of pruritus etiology,skin care,topical treatments,systemic medications,surgical treatments,adjunctive therapies,and psychological interventions.A management protocol for pruritus in cholestatic patients was developed.Conclusion In clinical practice,healthcare professionals should consider patient conditions and preferences to develop personalized treatment plans so as to improve the quality of life for patients.
维普
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