慢性心力衰竭患者自我容量管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.07.018

摘要/Abstract

摘要：

目的全面检索并汇总慢性心力衰竭患者自我容量管理的最佳证据,为临床医护人员及相关决策者提供思路和参考。方法系统检索BMJ Best Practice、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家临床医学研究所指南库、苏格兰院际指南网、美国国立指南库、Cochrane Library、PubMed、Embase、CINAHL、SinoMed、中国知网、万方数据知识服务平台,从建库至2021年5月4日与心力衰竭患者容量管理相关的所有文献,包括临床实践指南、最佳实践信息册、证据总结、专家共识等。由2名研究员对文献质量独立评价,提取并汇总形成最佳证据。结果共纳入9篇文献,包括临床实践指南7篇和专家共识2篇。从自我容量管理维持、容量超负荷感知以及容量超负荷应对3个方面共汇总了13条最佳证据。结论医护人员应通过循证的方法为慢性心力衰竭患者进行自我容量管理指导和咨询,帮助患者维持容量状态的平衡、尽早识别容量状态的变化并掌握基本的应对方法,从而改善患者的预后。

关键词: 心力衰竭, 自我容量管理, 容量管理, 容量超负荷, 自我管理, 证据总结

Abstract:

Objective To search,evaluate and summarize the best evidence of self volume-management for patients with chronic heart failure（CHF） based on the situation-specific theory of heart failure self-care. Methods The computer decision support systems,guideline websites,databases were systematically searched to collect the literature related to self volume-management in CHF patients. The retrieval period is from the establishment of databases to May 4th,2021. 2 researchers assessed the quality of the included literature independently and extracted the evidence. Results A total of 9 articles were included,including 7 clinical practice guidelines and 2 expert consensuses. A total of 13 pieces of evidence have been obtained from 3 aspects including self volume-management maintenance,symptom perception of volume overload,and volume overload management. Conclusion The best evidence should be used to help CHF patients maintain a balance of volume status,recognize changes in volume status as soon as possible,and learn some skills to respond appropriately to volume overload.

Key words: Heart Failure, Self Volume-Management, Volume Management, Volume Overload, Self-Management, Evidence Summary

罗桢蓝, 胡三莲, 朱凌燕, 徐梦琦, 阮甜甜. 慢性心力衰竭患者自我容量管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(7): 880-886.

LUO Zhenlan, HU Sanlian, ZHU Lingyan, XU Mengqi, RUAN Tiantian. Evidence summary for self volume-management in patients with chronic heart failure[J]. Chinese Journal of Nursing, 2022, 57(7): 880-886.

图/表 3

表1 纳入文献的一般特征（n=9）

Table 1 General characteristics included in the literature（n=9）

表2 纳入指南的质量评价结果（n=7）

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

表3 慢性心力衰竭患者自我容量管理的最佳证据总结

Table 3 Best evidence for the self volume-management in CHF patients

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