头颈部肿瘤患者吞咽功能促进策略的证据总结

doi:10.3761/j.issn.0254-1769.2023.01.012

摘要/Abstract

摘要：

目的检索、评价并总结头颈部肿瘤患者吞咽功能促进策略的最佳证据，为临床工作提供循证依据。方法遵循“6S”证据模型，系统检索UpToDate、BMJ最佳临床实践、国际指南协作网、美国指南网、加拿大安大略注册护士协会网站、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库、Cochrane Library、PubMed、Embase、CINAHL、Web of Science、中国知网、万方数据库等临床决策支持系统、指南网站、数据库及耳鼻喉头颈外科协会和吞咽障碍康复学会网站中关于头颈部肿瘤患者吞咽功能促进策略的所有证据，包括指南、系统评价、专家共识、临床决策、证据总结、最佳实践及高质量的原始研究，检索时限为建库至2021年12月1日。结果共纳入15篇文献，包括7篇指南、4篇系统评价、2篇专家共识和2篇证据总结，汇总了包含多学科协作、吞咽评估、吞咽障碍干预措施及随访4个方面的18条证据。结论吞咽功能促进策略可有效改善头颈部肿瘤患者的吞咽功能。医护人员在证据转化时，应结合临床实际情境及个体意愿为患者制订个性化的吞咽功能促进策略。

关键词: 头颈部肿瘤, 喉癌, 鼻咽癌, 吞咽障碍, 证据总结, 循证护理学

Abstract:

Objective To retrieve，evaluate and summarize the best evidence of strategies to promote swallowing function in patients with head and neck tumors，providing evidence-based evidence for clinical practice. Methods Following the “6S” evidence model，we searched the UpToDate，BMJ Best Practice，GIN，NGC，RANO，JBI，Cochrane Library，PubMed，Embase，CINAHL，Web of Science，CNKI，Wanfang and the International Otolaryngology Head and Neck Surgery and Dysphagia Association to collect the literature，including guidelines，systematic reviews，expert consensuses，clinical decisions，evidence summaries and recommended practices. The retrieval time was from inception to December 1st，2021. Results 15 articles were enrolled，including 7 guidelines，4 systematic reviews，2 expert consensuses and 2 evidence summaries. Finally，18 pieces of best evidence were summarized about multidisciplinary collaboration，swallowing assessment，interventions on dysphagia and follow-up. Conclusion The swallowing function promotion strategies can effectively improve the swallowing function of patients with head and neck tumors. When translating nursing evidence，healthcare professionals should formulate a personalized swallowing function promotion plan for patients based on the actual clinical situation and individual willingness.

Key words: Head and Neck Tumor, Laryngeal Carcinoma, Nasopharyngeal Carcinoma, Dysphagia, Evidence Summary, Evidence-Based Nursing

雷倍美, 李珍, 谢常宁, 岳丽青, 戴美玲, 黄瑞瑞, 罗爱红, 彭欢. 头颈部肿瘤患者吞咽功能促进策略的证据总结[J]. 中华护理杂志, 2023, 58(1): 85-90.

LEI Beimei, LI Zhen, XIE Changning, YUE Liqing, DAI Meiling, HUANG Ruirui, LUO Aihong, PENG Huan. Evidence summary for strategies to promote swallowing function in patients with head and neck tumors[J]. Chinese Journal of Nursing, 2023, 58(1): 85-90.

图/表 3

表1 纳入文献的一般特征（n=15）

Table 1 Characteristics of included studies（n=15）

表2 纳入指南的质量评价结果（n=7）

Table 2 The quality evaluation results of the guidelines（n=7）

表3 头颈部肿瘤患者吞咽功能促进策略的最佳证据

Table 3 Evidence summary of strategies for promoting swallowing function in patients with head and neck tumors

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