终末期肿瘤患者呼吸困难管理的证据总结

doi:10.3761/j.issn.0254-1769.2022.14.004

摘要/Abstract

摘要：

目的检索、评价并总结终末期肿瘤患者呼吸困难管理的最佳证据。方法系统检索UpToDate、BMJ最佳临床实践、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library、PubMed、Embase、中国知网等数据库中关于终末期肿瘤患者呼吸困难管理的证据,包括指南、证据总结、临床决策、推荐实践、系统评价、专家共识及Meta分析。检索时限为建库至2021年9月30日。由2名研究者进行文献质量评价和资料提取,并结合专业人员的判断,进行证据汇总。结果共纳入9篇文献,其中指南4篇,临床决策2篇,推荐实践1篇,证据总结1篇,系统评价1篇。汇总了关于症状筛查与评估、转诊、沟通与决策、非药物干预、药物干预、综合干预6个方面的20条证据。结论终末期肿瘤患者呼吸困难管理的证据可协助临床医护人员管理患者呼吸相关症状,为提升医院临终关怀质量提供循证依据。

关键词: 终末期, 肿瘤, 安宁疗护, 呼吸困难管理, 证据总结, 循证护理

Abstract:

Objective To retrieve and summarize the best evidence for the management of dyspnea in patients with terminal cancer. Methods We searched the evidence about the management of dyspnea in patients with terminal cancer in UpToDate,BMJ Best Clinical Practice,JBI Evidence-Based Practice Database,Cochrane Library,PubMed,Embase,CNKI and other databases,including guidelines,evidence summaries,clinical decision-makings,recommended practices,systematic reviews,expert consensuses and meta-analysis. The retrieval time limit is from the establishment of the database to September 30,2021. Literature quality assessment and data extraction were performed by 2 researchers. Results A total of 9 papers were included,involving 4 guidelines,2 clinical decisions,1 recommended practice,1 evidence summary,and 1 systematic review. 20 pieces of evidence were categorized into 6 aspects,including symptom screening and assessment,referral,communication and shared decision-making,nonpharmacologic intervention,pharmacologic intervention and comprehensive intervention. Conclusion The evidence summary on the management of dyspnea in terminal cancer patients can provide evidence-based evidence for clinical healthcare professionals to manage the dyspnea symptoms and improve end-of-life quality of patients with terminal cancer.

Key words: Terminal, Neoplasms, Palliative Care, Management of Dyspnea, Evidence Summary, Evidence-Based Nursing

唐如冰, 李繁荣, 韦珏伶, 林景, 韦双双, 杨莉洁, 游雪梅. 终末期肿瘤患者呼吸困难管理的证据总结[J]. 中华护理杂志, 2022, 57(14): 1690-1695.

TANG Rubing, LI Fanrong, WEI Jueling, LIN Jing, WEI Shuangshuang, YANG Lijie, YOU Xuemei. Summary of best evidence for the management of dyspnea in patients with terminal cancer[J]. Chinese Journal of Nursing, 2022, 57(14): 1690-1695.

图/表 4

图1 文献筛选流程图

Figure 1 Flow chart of literature screening

表1 纳入文献的基本特征（n=9）

Table 1 Sources and general characteristics of the included literature（n=9）

表2 指南的质量评价结果（n=4）

Table 2 The quality evaluation results of the included guidelines（n=4）

表3 终末期肿瘤患者呼吸困难管理的证据总结

Table 3 Summary of best evidence for the management of dyspnea in patients with terminal cancer

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