成人脑卒中患者吞咽障碍管理的证据总结
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Evidence summary on management of post-stroke dysphagia in adults patients
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    摘要:

    目的 遴选成人脑卒中患者吞咽障碍管理的最佳证据,提高管理效果。方法 计算机检索 BMJ最佳临床实践、UptoDate、 Cochrane图书馆、美国指南网、JBI证据总结数据库、加拿大安大略注册护士网、CINAHL数据库、PubMed、国际指南协作网、中国 临床指南文库、中国知网和中国生物医学文献数据库有关成人脑卒中患者吞咽障碍管理证据。采用临床指南研究与评价系统、 2014版JBI证据预分级及推荐级别系统分别对各类研究进行文献质量评价及证据级别评定。结果 共纳入21篇文献,遴选出具 备临床适用性证据15条,涉及吞咽困难的识别、筛查、治疗、给药、营养支持及口腔护理等方面。结论 本研究遴选的最佳证据,可 应用于成人脑卒中患者吞咽障碍管理实践中;应用前需评估证据的促进和阻碍因素、患者意愿及偏好等,以选择个体适用证据。

    Abstract:

    Objective To summarize the available best evidences on management of post-stroke dysphagia among adult patients, and to help improve effect of management. Methods We searched the such databases as BMJ best practice, up to date, Cochrane Libra-ry, National Guideline Clearing house, Joanna Briggs Institute Library, RANO, CINAHL, PubMed, GIN, CGN, CNKI and CBM, to collect all the evidence regarding management of post-stroke dysphagia among adult patients. Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) was used to appraised the evidence, and the Joanna Briggs Institute Levels of Evidence and Grades of Recommendation (2014) were used to rate the evidence. Results A total of 15 pieces of evidence feasible and applicable in clinical context were summarized from 21 publications, covering such aspects as swallowing identification, screening, treatment, drug delivery principles, nutritional support and oral care. Conclusion The best evidence selected in this study can be applied in the management of dysphagia in adult stroke patients. Before application of the evidence in clinical context, it is necessary to consider the facilitators and barriers, and patients′ willingness and preferences, and select individual specific evidence.

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乐革芬,余鹏,汪欢,王羡科,许妮娜,詹昱新,张丽华.成人脑卒中患者吞咽障碍管理的证据总结[J].护理学杂志,2019,34(7):42-46

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  • 收稿日期:2018-11-18
  • 最后修改日期:2018-12-26
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  • 在线发布日期: 2022-08-09