慢性呼吸道疾病患者非药物气道廓清技术的最佳证据总结  

Summary of the best evidence for non-pharmacological airway clearance techniques in patients with chronic respiratory disease

作　　者：郑江 汉瑞娟 王岩[3] 张红霞 柴梅梅 祁万君 李玉兰 ZHENG Jiang;HAN Ruijuan;WANG Yan;ZHANG Hongxia;CHAI Meimei;QI Wanjun;LI Yulan

机构地区：[1]兰州大学护理学院,兰州市730000 [2]解放军联勤保障部队第九四〇医院呼吸与危重症医学科,兰州市730000 [3]兰州大学第一医院门诊部,兰州市730000 [4]甘肃中医药大学护理学院,兰州市730000

出　　处：《中华护理杂志》2023年第10期1253-1260,共8页Chinese Journal of Nursing

基　　金：甘肃省2021年度第十一批省级科技计划项目(21JR11RA009)

摘　　要：目的 总结慢性呼吸道疾病患者非药物气道廓清技术的最佳证据。方法 计算机检索国内外数据库、指南网、临床决策支持系统及呼吸专业相关协会网站等,检索文献类型包括指南、专家共识、临床决策、推荐实践、系统评价等,检索时限为建库至2022年5月。由2名研究者评价文献质量和汇总证据。结果 共纳入16篇文献,包括6篇指南、6篇专家共识、1篇推荐实践、3篇系统评价。从治疗前评估、干预措施、注意事项、频率与时间、疗效评估及健康教育6个方面,汇总了20条非药物气道廓清技术的证据,同时汇总了包括有效咳嗽或用力呼气、手法辅助咳嗽、主动循环呼吸技术、自体引流、手法治疗、体位引流、高频胸壁振荡、呼气正压或振荡呼气正压8项非药物气道廓清技术的32条使用原则。结论 医护人员在临床应用非药物气道廓清技术时,应根据患者的个体情况,审慎地制订气道廓清方案,以促进患者获益最大化。Objective To summarize the best evidence for non-pharmacological airway clearance techniques in patients with chronic respiratory diseases.Methods We searched domestic and international databases,guideline networks,clinical decision support systems and websites of respiratory professional associations.The types of the literature include guidelines,expert-consensuses,clinical decision-making,recommended practices and systematic reviews.The retrieval time is from the establishment of the databases to May 2022.There were 2 investigators who evaluated the quality of the literature and pooled evidence.Results A total of 16 publications were included,involving 6 guidelines,6 expert consensus articles,1 recommended practice,and 3 systematic reviews.A summary of the best evidence for the overall requirements of 20 airway clearance techniques in 6 areas,namely pre-treatment assessment,interventions,precautions,frequency and duration,assessment of efficacy and health education.8 commonly used airway clearance techniques were also summarized,with 32 pieces of evidence for the principles of use,including effective cough or huffing,maneuver-assisted cough,active cycle of breathing techniques,autogenous drainage,manual techniques,postural drainage,high-frequency chest wall oscillatory,and positive expiratory pressure or oscllating positive expiratory pressure.ConclusionIn the clinical application of non-pharmacological airway clearance techniques,medical staff should carefully formulate airway clearance techniques plan according to the individual situation of patients,so as to maximize the benefits of patients.

关 键 词：呼吸道疾病 气道廓清 非药物干预 循证护理学 证据总结 

分 类 号：R473.5[医药卫生—护理学]