摘要
目的评价并总结尿毒症患者皮肤瘙痒管理的相关证据,为临床提供参考依据。方法系统检索UpToDate、英国国家卫生与临床优化研究所网站、苏格兰校际指南网络、美国国立指南库、医脉通、BMJ Best Practice、Cochrane Library、JBI循证卫生保健中心图书馆、国际指南协作网、国际肾脏病学会、PubMed、CINAHL、EMbase、Web of Science、ScienceDirect、中国知网、万方数据库、中国生物医学文献服务系统、维普数据库关于尿毒症患者皮肤瘙痒管理的相关证据,检索时间为建库至2022年2月。由2名具有循证护理知识的研究人员独立对文献进行质量评价和证据级别评定。结果共纳入15篇文献,包括3篇临床决策、1篇指南、1篇推荐实践、1篇证据总结、8篇系统评价和1篇专家共识。总结包括对尿毒症瘙痒的评估、透析管理、用药管理、局部瘙痒管理、补充替代疗法、生活指导和心理指导7个方面的22条最佳证据。结论该研究总结并形成了尿毒症患者皮肤瘙痒管理方案,医护人员在临床转化时需结合临床实际,考虑患者的自身状况和意见,为尿毒症瘙痒患者制定个性化的管理计划,以进一步提高患者的生活质量。
Objective To evaluate and summarize the evidence of management of skin pruritus in uremic patients,and to provide reference for clinical practice.Methods We searched UpToDate,National Institute for Health and Clinical Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),National Guideline Clearinghouse(NGC),www.Medlive.cn,BMJ Best Practice,Cochrane Library,JBI Evidence-based Health Care International Collaborating Center Library,Guideline International Network(GIN),International Society of Nephrology(ISN),PubMed,CINAHL,Embase,Web of Science,ScienceDirect,CNKI,Wanfang Database,CBM,and VIP Database to collect evidence on management for patients with uremic pruritus(UP).The retrieval period was from the inception of the databases to February 2022.Two researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence.Results Fifteen pieces of literature were included,including 3 clinical decisions,1 recommended practice,1 evidence summary,1 guideline,8 systematic evaluations and 1 expert consensus.Twenty-two pieces of best evidence of 7 dimensions of management of UP patients were summarized,including assessment,dialysis management,medication management,local itch management,complementary and alternative therapy,life and psychological guidance.Conclusion This study summarizes and forms the management of patients with UP.Personalized management should be considered for patients with UP based on clinical practice and patients’conditions and opinions during the clinical transformation of evidence,thus to further improve the quality of life of patients with UP.
作者
林晓露
周春兰
杨玲莉
张咪
王润
赵慧慧
LIN Xiao-lu;ZHOU Chun-lan;YANG Ling-li;ZHANG Mi;WANG Run;ZHAO Hui-hui(Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)
出处
《护理学报》
北大核心
2022年第17期38-42,共5页
Journal of Nursing（China）
基金
南方医院护理创优循证护理项目(2021EBNc001)。
关键词
尿毒症
终末期肾病
血液透析
腹膜透析
皮肤瘙痒
循证护理
uremia
end-stage renal disease
hemodialysis
peritoneal dialysis
skin pruritus
evidence-based nursing
