摘要
目的 总结维持性血液透析(MHD)患者高钾血症预防与管理的最佳证据。方法 依据“6S”证据金字塔模型,在国内外相关网站和数据库中检索与MHD患者高钾血症预防与管理相关的证据,包括临床决策、临床实践指南、专家共识/专家建议、证据总结与系统评价。评价文献质量后,提取并汇总证据。结果 最终纳入10篇文献,其中3篇临床决策、4篇临床实践指南、3篇专家共识/专家建议。从管理目标与风险评估、饮食管理、血液透析优化、升钾药物管理、降钾药物干预、合理监测6个维度生成25条最佳证据。结论 基于MHD患者高钾血症预防与管理的最佳证据,医护人员可结合患者情况与临床实际情况选取合适的证据制订适宜的防治方案,以降低MHD患者高钾血症的发生率,提高患者的生活质量。
Objective To summarize the best evidence for the prevention and management of hyperkalemia in patients undergoing maintenance hemodialysis(MHD).Methods Based on the"6S"evidence pyramid model,evidence related to the prevention and management of hyperkalemia in MHD patients was retrieved from domestic and overseas relevant websites and databases,including clinical decision-making,clinical practice guidelines,expert consensus/recommendations,evidence summary,and systematic reviews.After evaluating quality of the literature,evidence was extracted and summarized.Results A total of 10 literature was eventually enrolled,therein there were 3 articles of clinical decision-making,4 articles of clinical practice guidelines,3 articles of expert consensus/recommendations.A total of 25 pieces of best evidence were generated from 6 dimensions,including management objectives and risk assessment,diet management,hemodialysis optimization,potassium raising drug management,potassium lowering drug intervention,and reasonable monitoring.Conclusion Based on the best evidence for the prevention and management of hyperkalemia in MHD patients,medical staff can select appropriate evidence and formulate appropriate prevention and treatment regimen in combination with patients′conditions and clinical actual conditions,so as to decrease the incidence rate of hyperkalemia in MHD patients,and to improve the quality of life in patients.
作者
冯倩
韩晓苇
李淑贤
朱梦霞
齐士坤
FENG Qian;HAN Xiaowei;LI Shuxian;ZHU Mengxia;QI Shikun(The Fourth School of Clinical Medicine,Guangzhou University of Chinese Medicine,Shenzhen 518033,Guangdong,China;Department of Traditional Chinese Medicine Health Management,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033,Guangdong,China)
出处
《广西医学》
CAS
2023年第23期2893-2900,共8页
Guangxi Medical Journal
关键词
高钾血症
维持性血液透析
最佳证据
预防
管理
循证医学
Hyperkalemia
Maintenance hemodialysis
Best evidence
Prevention
Management
Evidence-based medicine
