摘要
目的检索、评价和整合恶性肿瘤伤口症状管理的最佳证据,为临床提供实践参考,以改善恶性肿瘤患者伤口症状情况,提高患者生活质量。方法遵循“6S”证据模型,计算机检索国际指南协作网、美国指南网、英国国家临床优化研究所、苏格兰校际指南网、加拿大安大略护士注册网、中国指南网、UpToDate、JBI图书馆、中国知网(CNKI)等数据库有关恶性肿瘤伤口症状管理的高级别证据。检索时段为建库至2019年12月。结果共纳入15篇文献,包括2篇指南、1篇临床决策、3篇证据总结、9篇系统评价。从伤口评估、评估工具选择、伤口清洗、伤口清创、伤口敷料的选择与使用、气味管理、渗液管理、出血管理、疼痛管理、瘙痒管理、营养管理11个方面进行证据综合,最终获取48条最佳证据。结论恶性肿瘤伤口症状管理的最佳证据可为临床医护人员提供实践参考。医护人员应结合科室临床环境选择并应用最佳证据,以科学的方法管理恶性肿瘤伤口症状,可提高患者的生活质量。
Objective To search,evaluate and integrate the best evidence regarding symptoms management of malignant fungating wounds,to provide a practical reference for clinical practice,to improve wounds symptoms in patients with malignant tumor and improve patient quality of life.Methods We searched such databases as Guidelines International Network(GIN),National Guidelines Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),Registered Nurses'Association of Ontario,China Guidelines Clearinghouse,UpToDate,JBI,CNKI,etc.,for high level evidence on symptoms management of malignant fungating wounds published from inception of the databases through December 2019.Results A total of 15 literatures(2 guidelines,1 clinical decision report,3 evidence summary reports and 9 systematic reviews)were included.Eleven aspects,which included wounds assessment,the selection of assessment tools,wounds cleaning,wounds debridement,wounds dressing selection and use,odor management,exudate management,bleeding management,pain management,itch management,and nutrition management,were extracted from 48 pieces of best evidence.Conclusion The best evidence regarding symptoms management of malignant fungating wounds can provide a practical reference for clinical medical staff.Medical staff need to consider clinical environment of the unit before applying the best evidence to manage the symptoms of malignant fungating wounds scientifically,which could improve the quality of life of patients.
作者
周帅
江锦芳
覃彦珠
张玲
刘鑫
张兰芳
Zhou Shuai;Jiang Jinfang;Qin Yanzhu;Zhang Ling;Liu Xin;Zhang Lanfang(Department of Nursing,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《护理学杂志》
CSCD
北大核心
2020年第20期92-97,共6页
Journal of Nursing Science
基金
2018年广西马克思主义理论研究和建设工程(广西医科大学研究基地)、广西高校人文重点研究基地(健康与经济社会发展研究中心)课题(2018RWB11)
广西壮族自治区卫生健康委员会自筹经费课题(Z20190816)。
关键词
恶性肿瘤
伤口
症状管理
评估
清创
敷料
气味管理
渗液管理
证据总结
malignant tumor
wounds
symptoms management
assessment
debridement
dressing
odor management
exudate management
evidence summary
