鼻咽癌患者口咽部症状护理临床实践指南的系统评价  

Clinical Practice Guidelines on Oropharyngeal Symptoms Nursing for Patients with Nasopharyngeal Carcinoma:A Systematic Review

作　　者：李珍[1,2] 周梦娟 刘靓晔 雷倍美 戴美玲 罗爱红[1] 岳丽青[1] LI Zhen;ZHOU Mengjuan;LIU Liangye;LEI Beimei;DAI Mengling;LUO Aihong;YUE Liqing(Teaching and Research Section of Clinical Nursing,Xiangya Hospital,Central South University,Changsha 410000,Hunan Province,China;Department of Otorhinolaryngology Head and Neck Surgery,Xiangya Hospital,Central South University;School of Nursing,Dali University,Dali 671000,Yunnan Province,China;Department of Neurology,Beijing Tongren Hospital,Beijing 100000,China;Department of Nursing,The First Affiliated Hospital of Xi’an Medical College,Xi’an 710077,Shaanxi Province,China)

机构地区：[1]中南大学湘雅医院临床护理学教研室,湖南长沙410000 [2]中南大学湘雅医院耳鼻咽喉头颈外科 [3]大理大学护理学院,云南大理671000 [4]北京同仁医院神经内科,北京100000 [5]西安医学院第一附属医院护理部,陕西西安710077

出　　处：《军事护理》2022年第11期77-80,共4页MILITARY NURSING

基　　金：湖南省科技发展计划(创新平台与人才计划)项目(2017TP1004)。

摘　　要：目的检索鼻咽癌患者口咽部症状护理相关指南,并进行质量评价和内容分析,为临床提供参考。方法系统检索指南网、头颈部肿瘤相关学会、数据库等,检索日期为建库至2022年3月1日。采用临床指南研究和评价系统(the appraisal of guidelines for research evaluation instrument,AGREE II)对指南进行质量评价。结果共纳入4篇指南、3篇专家共识。指南总体质量评价为1篇A级、3篇B级,专家共识真实性较好。提取6个方面内容:放射性口腔干燥症的应对、放射性口腔黏膜炎及感染的管理、放射性龋齿的护理、张口受限的训练、吞咽障碍的干预、随访管理,共23条推荐意见。结论纳入的鼻咽癌口咽部症状护理相关的指南总体质量中等,其指南开发的参与人员、严谨性、应用性和独立性领域均有待提高。目前我国尚缺乏高质量的鼻咽癌患者口咽部症状护理相关实践指南,整合的推荐意见具有较好的实践意义。建议在借鉴国外高质量指南的基础上制定本土化循证指南,以指导临床实践。Objective To search relevant guidelines on oropharyngeal symptoms nursing for patients with nasopharyngeal carcinoma,and conduct quality appraisal and content analysis,so as to provide references for clinical practice.Methods The guidelines network,head and neck tumor related associations,and databases were systematically retrieved.The retrieval time frame was from inception to March 1st,2022.The Appraisal of Guidelines for Research Evaluation Instrument(AGREE II)was used to appraise the quality of guidelines.Results A total of 4 guidelines and 3 expert consensuses were included.The quality of one guideline was level A,and the other three guidelines ranked level B.All expert consensuses reported good authenticity.Six aspects of the contents were extracted,including coping with radioactive xerostomia,management of radioactive oral mucositis and infection,nursing of radioactive dental caries,training for mouth opening restrictions,interventions on swallowing disorders,and follow-up management.A total of 23 recommendations were summarized.Conclusions The overall quality of involved guidelines on oropharyngeal symptoms nursing of nasopharyngeal carcinoma is moderate.The quality of dimensions on developers,preciseness,applicability and independence of the guidelines need to be improved.Nowadays,there is still a lack of high-quality practice guidelines for oropharyngeal symptoms nursing for patients with nasopharyngeal carcinoma in China.Integrated recommendations have valuable practical significance.It is suggested that domestic evidence-based guidelines should be formulated on the basis of foreign high-quality guidelines,so as to direct clinical practice.

关 键 词：鼻咽癌 口腔干燥 口腔黏膜炎 吞咽障碍 实践指南 质量评价 

分 类 号：R473.76[医药卫生—护理学]