经口进食的脑卒中后吞咽障碍病人误吸预防的最佳证据总结  

Summary of the best evidence for the prevention of aspiration in stroke patients with dysphagia after oral feeding

作　　者：师丽娜 张士变 霍晓冉 张驰[2] 王梦 王昊 冯英璞[2] SHI Lina;ZHANG Shibian;HUO Xiaoran;ZHANG Chi;WANG Meng;WANG Hao;FENG Yingpu(School of Nursing and Health,Henan University,Henan 475000 China)

机构地区：[1]河南大学护理与健康学院,河南475000 [2]河南省人民医院

出　　处：《循证护理》2023年第15期2670-2676,共7页Chinese Evidence-Based Nursing

基　　金：2021年度河南省医学科技攻关计划软科学项目,编号:RKX202102005。

摘　　要：目的:检索汇总及评价经口进食的脑卒中后吞咽障碍病人误吸预防的相关证据,并对证据进行分析总结。方法:按照“6S”证据模型从上至下检索国内外数据库关于经口进食的脑卒中后吞咽障碍病人误吸预防的证据,包括指南、临床决策、证据总结及专家共识。检索时限为建库至2021年10月1日。由2名研究者使用临床指南研究与评价系统Ⅱ(AGREEⅡ)对指南进行质量评价,使用Joanna Briggs Institutes(JBI)循证卫生保健中心对应的评价标准(2016)对系统评价、专家共识、类试验研究、描述性研究进行质量评价,并进行证据提取和汇总分析。结果:共纳入16篇文献,包括10篇指南、2篇临床决策、3篇专家共识和1篇证据总结,形成了21条最佳证据,主要内容包括吞咽障碍的筛查、饮食管理、口服固体药物管理、口腔护理、观察与应急处理及教育与培训。结论:总结了经口进食的脑卒中后吞咽障碍病人误吸预防的最佳证据,为护理人员对经口进食的脑卒中后吞咽障碍病人误吸的预防工作提供科学的依据,促进护理质量的提高。Objective:To retrieve,summarize and evaluate relevant evidence on the prevention of aspiration in stroke patients with dysphagia after oral feeding and analyze and summarize the evidence.Methods:According to the"6S"evidence model,search domestic and foreign databases from top to bottom for evidence on the prevention of aspiration in stroke patients with dysphagia after oral feeding,including guidelines,clinical decision-making,evidence summary,and expert consensus.The retrieval time was from the inception to October 1,2021.Two researchers used AGREEⅡto evaluate the quality of the guidelines,and used the evaluation criteria corresponding to the Joanna Briggs Institutes(JBI)Evidence Based Health Care Center(2016)to evaluate the quality of system evaluations,expert consensus,quasi experimental studies,and descriptive studies.Evidence was extracted and summarized for analysis.Results:A total of 16 articles were included,including 10 guidelines,2 clinical decisions,3 expert consensus papers,and 1 evidence summary,forming 21 best evidence pieces.The main content included screening for swallowing disorders,dietary management,oral solid drug management,oral care,observation and emergency response,and education and training.Conclusion:Summarized the best evidence for the prevention of aspiration in stroke patients with dysphagia who ingest orally,providing scientific basis for nursing staff to prevent aspiration in stroke patients with dysphagia who ingest orally,and promoting the improvement of nursing quality.

关 键 词：脑卒中 吞咽障碍 误吸 预防 循证护理 证据总结 

分 类 号：R473.74[医药卫生—护理学]