摘要
[目的]循证糖尿病足部溃疡的伤口评估、处理以及疗效评价的最佳实践方案。[方法]在Cochrane循证医学数据库、澳大利亚JBI循证卫生保健数据库、美国国立指南数据库(National Guideline Clearinghouse,NGC)、加拿大安大略注册护士协会循证护理指南网(Registered Nurses Association of Ontario,RNAO)、Best Practice数据库、Nursing Reference Center数据库、国际伤口网(www.woundsinternational.com)、中国期刊全文数据库(Chinese Academic Journals,CAJ)、ScienceDirect、Journals@Ovid Full Text等学术期刊网络数据库中检索2007年—2017年发表的临床实践指南、系统评价及其他循证研究资源。[结果]检索到的循证资源包括6篇国际糖尿病足工作组临床指南、1篇国际伤口实践指南、2篇RNAO最佳实践指南、1篇JBI(Joanna Briggs Institute)系统评价、3篇Cochrane系统评价及7篇糖尿病足溃疡治疗的系统评价。来自循证实践推荐方案包括清除坏死组织、局部减压、局部用药、高压氧治疗、负压伤口治疗、全身抗感染治疗、控制血糖和健康教育等,同时进行疗效评价。[结论]应重视糖尿病病人的足部评估包括伤口的部位、肤色、温度和感染分级程度。建议进一步分析糖尿病足溃疡评估与处理的系统评价研究文献,结合临床治疗与护理特点,探讨糖尿病足溃疡护理的最佳临床实践指南。
Objective：To describe the evidence-based practice for wound assessment,management and evaluation in diabetic foot ulcers.Method：A review of the published clinical practice guidelines,systematic reviews and other evidence-based research resources between 2007 to 2017 was undertaken using the following databases：Cochrane evidence-based medicine database,Australian Joanna Briggs Institute evidence-based healthcare databases,National guideline clearinghouse,Evidence-based nursing guide network in Registered Nurses Association of Ontario,Best practice,Nursing reference center,Website of wounds international and Chinese academic journals,ScienceDirect and Journals@Ovid Full Text.Results：The retrieved evidence-based resources included six clinical guidelines for the International Diabetes Foot Working Group,one International Wound Practice Guide,two Registered Nurses Association of Ontario Best Practices Guide,and one JBI systematic review,three Cochrane systematic reviews,and seven systematic reviews of diabetic foot ulcer therapy.The recommendations from evidence-based practice include removal of necrotic tissue,local decompression,topical treatment,hyperbaric oxygen therapy,negative pressure wound treatment,systemic anti-infective therapy,control of blood glucose and health education,and the effects should be continuously evaluated.Conclusion：Attention should be paid to the foot assessment of diabetic patients,including the location of the wound,skin color,temperature and infection grading.Recommendation：It needs to further analyze the systematic reviews on the wound assessment and management on diabetic foot ulcers.Combined with clinical treatment and nursing characteristics,the best clinical practice guidelines on diabetic foot ulcers should be explored.
出处
《循证护理》
2017年第5期436-440,共5页
Chinese Evidence-Based Nursing
关键词
糖尿病足溃疡
伤口评估
处理
循证实践
diabetic foot ulcer
wound assessment
treatment
evidence - based practice
