Abstract:

Objective To retrieve,evaluate and integrate domestic and foreign evidence on the prevention and nursing care of chemotherapy-induced alopecia in breast cancer patients,and to summarize the best evidence. Methods We systematically searched the evidence in databases such as UpToDate,Cochrane Library,JBI,BMJ,NICE,RNAO,SIGN,ASCO,ONS,MASCC,etc.,for high level evidence on prevention and nursing care of chemotherapy-induced alopecia in breast cancer patients,including guidelines,best practice information sheets,expert consensuses,systematic reviews and evidence summaries. The retrieval period was from the inception of databases to December 2020. Two researchers independently completed the quality evaluation of the included literature,and combining with the judgment of professionals,they extracted and summarized the evidence of the literature which the quality conformed to the standard. Results A total of 18 articles were incorporated,including 9 guidelines,4 systematic reviews and 5 expert consensuses. 19 aspects were summarized,including team building,assessment content,physical prevention,drug prevention,cosmetic,psychological care,health education and other hair changes. Conclusion The best evidence for prevention and nursing care of chemotherapy-induced alopecia in breast cancer can provide references for clinical doctors and nurses,but the best evidence should be selected according to the environment of the department and patients’ preferences. The symptoms of chemotherapy-induced alopecia should be managed in a scientific way,in order to improve the quality of nursing care and the quality of life of patients.

Key words: Breast Neoplasms, Chemotherapy, Alopecia, Prevention, Evidence Summary, Evidence-Based Nursing

摘要：

目的 检索、评价并整合国内外关于乳腺癌患者化疗所致脱发预防及护理的相关证据,并对最佳证据进行总结。 方法 系统检索UpToDate、Cochrane Library、乔安娜布里格斯研究所循证卫生保健中心数据库、British Medical Journal最佳临床实践、英国国家临床优化研究所网站、加拿大安大略护理学会网站、苏格兰校际指南网络以及美国临床肿瘤协会、肿瘤护理学会、多国癌症支持护理协会等专业协会网站中所有关于乳腺癌患者化疗所致脱发预防及护理的证据,包括指南、最佳临床实践信息册、专家共识、系统评价、证据总结,检索时限为建库至2020年12月20日。由2名研究者独立完成纳入文献的质量评价,并结合专业人士的判断,对符合标准的文献进行证据提取及总结。 结果共纳入18篇文献,其中9篇指南,4篇系统评价,5篇专家共识,总结出19条最佳证据,包括多学科合作团队、评估内容、预防措施、化妆美容、心理护理、健康教育6个方面。 结论 乳腺癌患者化疗所致脱发预防及护理的最佳证据可为临床医护人员实践提供参考,但应结合科室环境、患者喜好选择应用最佳证据,以科学的方法管理化疗所致脱发症状,提升护理质量,提高患者的生存质量。

关键词: 乳腺肿瘤, 化疗, 脱发, 预防, 证据总结, 循证护理学