特发性炎性肌病患者吞咽障碍管理的最佳证据总结  

Evidence summary of best practice on the management of dysphagia in patients with idiopathic inflammatory myopathy

作　　者：朱昱璇 徐任菊 卞文娟 邱茜叶 刘媛媛[1] 徐梦婕 仲莹莹 ZHU Yuxuan;XU Renju;BIAN Wenjuan;QIU Qianye;LIU Yuanyuan;XU Mengjie;ZHONG Yingying(Department of Rheumatology and Immunology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属鼓楼医院风湿免疫科,江苏南京210008

出　　处：《护士进修杂志》2024年第15期1629-1635,共7页Journal of Nurses Training

基　　金：南京鼓楼医院护理科研基金资助项目(编号:ZSA808)。

摘　　要：目的评价、总结特发性炎性肌病(idiopathic inflammatory myopathy,IIM)患者吞咽障碍管理的最佳实践证据,为其科学化管理提供依据。方法系统检索Up To Date、美国国立指南网、英国国家医疗保健优化研究所等相关指南网,欧洲吞咽障碍学会、欧洲抗风湿病联盟、美国风湿病学会各专业协会网站和PubMed、Cochrane Library等数据库关于IIM患者吞咽障碍的临床决策指南、专家共识、证据总结和系统评价,检索时限为建库至2022年4月20日。由2名研究者独立完成文献质量评价和内容提取,依据证据预分级系统确定证据等级。结果共纳入20篇文献,包括1篇临床决策、5篇指南、4篇系统评价、9篇专家共识和1篇证据总结,最终形成最佳证据20条,包括多学科团队、吞咽障碍筛查与评估、药物干预等8个主题。结论吞咽障碍的早期筛查与评估对IIM患者疾病管理至关重要,医护人员应选择适宜的工具对IIM患者进行吞咽功能常规筛查,以及时识别和干预吞咽困难,减少患者营养不良及吸入性肺炎等并发症的发生率。Objective To evaluate and summarize the best practice evidence of the management of dysphagia in patients with idiopathic inflammatory myopathy(IIM),and provide basis for its scientific management of dysphagia.Methods The clinical decisions,guidelines,expert consensus,evidence summary,and system evaluation of the IIM patients' dysphagia in Up To Date,National Guideline Clearinghouse,National Institute for Health and Clinical Excellence and other guideline websites,and European Society for Swallowing Disorders,The European League Against Rheumatism,and American College of Rheumatology websites,PubMed,Cochrane Library,and other databases were systematically searched,and the retrieval time was from the establishment of the database to April 20,2022.Literature quality evaluation and content extraction were carried out by 2 researchers,and the evidence grade was determined according to the evidence pre-grading system.Results A total of 20 articles were included,including 1 clinical decisions,5 guidelines,4 systematic review,9 specialized consensus,and 1 evidence summary,and 20 pieces of best evidences were finally formed,including 8 topics which were multidisciplinary team,dysphagia screening and assessment,drug intervention,etc.Conclusion Early screening and evaluation of dysphagia in patients with IIM is critical to disease management.Healthcare professionals should choose appropriate tools to routinely screen patients with IIM for swallowing function,so as to identify and intervene in dysphagia in a timely manner,and reduce the incidence of complications such as malnutrition and aspiration pneumonia.

关 键 词：特发性炎性肌病 皮肌炎 吞咽障碍 证据总结 循证护理 

分 类 号：R593.2[医药卫生—内科学] R471[医药卫生—临床医学]