肺结核患者规范化痰标本采集的最佳证据总结

doi:10.3761/j.issn.0254-1769.2021.08.018

摘要/Abstract

摘要：

目的检索、评价并总结肺结核患者痰标本采集的最佳证据。方法系统检索BMJ Best Practice、UpToDate、WHO官网、加拿大安大略省注册护士协会网站、英国国家卫生与临床优化研究所官网、国际指南协作网、美国感染病学会网、Cochrane Library、CINAHL（EBSCO）、 Embase（OVID）、PubMed、Web of Science、乔安娜布里格斯研究所循证卫生保健中心、中国知网、万方数据库、维普数据库、中国生物医学数据库等关于肺结核患者痰标本采集的证据,包括指南、推荐实践、证据总结、专家共识、系统评价等。由2名研究者独立对纳入文献进行质量评价和资料提取,并结合专业人员的判断,对文献进行证据汇总。结果共纳入13篇文献,其中指南6篇,系统评价3篇,专家共识4篇,从采集前评估、采集前干预、采集方式、痰标本评估与转运、职业防护、健康教育6个方面汇总24条最佳证据。结论该研究总结肺结核患者痰标本采集的最佳证据,为临床提供循证依据。临床护理人员需充分评估临床实际情境及患者意愿,对证据进行选择性应用,以提高肺结核患者痰标本采集有效性。

关键词: 肺结核, 痰, 证据总结, 循证护理学

Abstract:

Objective To summarize the best evidence of sputum collection methods for patients with pulmonary tuberculosis. Methods We searched websites and databases including, but not limited to, BMJ best practice, UpToDate, World Health Organization, Registered Nurses’ Association of Ontario, National Institute for Health and Care Excellence, Guidelines International Network, Infectious Diseases Society of America,Cochrane Library,CINAHL（EBSCO）, EMBASE（OVID）, PubMed, Web of Science, JBI, CNKI, Wanfang, VIP, and CBM. Guidelines,recommended practices,evidence summaries,expert consensuses, and systematic reviews regarding collection methods of sputum samples for patients with pulmonary were considered. 2 researchers independently assessed methodological quality of included papers and extracted data. Results A total of 13 papers were identified including 6 guidelines, 3 systematic reviews,and 4 expert consensuses. 24 pieces of evidence were categorized into 6 aspects including pre-collection evaluation,pre-collection intervention,collection methods,sputum sample evaluation and transportation,occupational protection, and patient education. Conclusion This evidence summary provided sufficient evidence-based information for healthcare professionals to conduct sputum specimen collection for patients with pulmonary tuberculosis. Healthcare professionals should also consider feasibility, appropriateness, meaningfulness, and effectiveness of evidence in local context before adopting a certain method of sputum collection.

Key words: Tuberculosis, Sputum, Evidence Summary, Evidence-Based Nursing

龚贝贝,米元元,韦彩云,黄海妹,吴金艳,玉明柳,刘宁梅,朱政. 肺结核患者规范化痰标本采集的最佳证据总结[J]. 中华护理杂志, 2021, 56(8): 1229-1235.

GONG Beibei,MI Yuanyuan,WEI Caiyun,HUANG Haimei,WU Jinyan,YU Mingliu,LIU Ningmei,ZHU Zheng. Evidence summary of sputum collection methods for patients with pulmonary tuberculosis[J]. Chinese Journal of Nursing, 2021, 56(8): 1229-1235.

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