干燥综合征患者干眼症状管理的最佳证据总结  

Summary of Best Evidence for the Management of Dry Eye Symptoms in Patients with Sjögren's Syndrome

作　　者：史君伟 王鑫浩 徐炜 SHI JunWei;WANG XinHao;XU Wei(Wuxi Medical College of Ji-angnan University,Wuxi 214122,China;Minda Hospital of Hubei Minzu University,Enshi 445000,China;Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200336,China)

机构地区：[1]江南大学无锡医学院,无锡214122 [2]湖北民族大学附属民大医院,恩施445000 [3]上海交通大学医学院附属同仁医院,上海200336

出　　处：《中国中医眼科杂志》2025年第4期395-400,共6页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金项目(82272165);上海交通大学交叉学科创新人才实践培养基地项目;上海市长宁区医学硕博士创新人才基地项目(RCJD2022S01)。

摘　　要：目的总结干燥综合征(SS)患者干眼症状管理的最佳证据。方法采用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心的“PIPOST”模式构建循证护理问题,根据“6S”证据资源金字塔模型自上至下检索BMJ Best Practice、UpToDate等国内、外中英文数据库中有关SS患者干眼症状管理的临床决策、临床指南、专家共识、系统评价等相关证据,检索时间为建库至2024年2月18日。筛选符合质量标准的文献,对不同类型的文献分别进行质量评价并提取证据,采用JBI证据分级及证据推荐级别系统(2014年版)对纳入的证据进行分级及推荐。结果(1)一般情况:共纳入文献11篇,其中临床决策4篇、临床指南2篇、专家共识4篇、系统评价1篇。(2)文献质量:11篇纳入文献的质量整体较高。(3)最佳证据:共从9个方面汇总了23条证据。首先明确管理目标,依托主、客观评估工具建立动态监测基线,筛查可控风险因素;继而通过多学科资源整合制定分层干预方案,涵盖基础药物治疗优化、特殊场景风险控制、分级症状应对策略以及医源性操作警示;最终通过全周期健康教育体系巩固管理成效,以提升SS患者干眼管理的科学性与实效性,最终实现症状控制与生活质量的协同改善。结论本研究汇总的SS患者干眼症状管理的最佳证据,包括9个方面,23条证据,可为临床医护人员开展临床实践提供参考。OBJECTIVE To summarize the best evidence for the management of dry eye symptoms in patients with Sjögren's syndrome(SS).METHODS The evidence-based nursing question was constructed using the"PIPOST"model developed by the Joanna Briggs Institute(JBI)Centre for Evidence-Based Healthcare in Australia.Based on the"6S"evidence pyramid model,a systematic search was conducted from database inception to February 18th,2024,in both Chinese and international databases,including BMJ Best Practice and UpToDate,for clinical decision-making documents,clinical guidelines,expert consensus statements,and systematic reviews related to the management of dry eye symptoms in SS patients.Literature meeting quality standards was screened,assessed for quality based on different study types,and evidence was extracted.The included evidence was graded and recommended according to the 2014 edition of the JBI Levels of Evidence and Grades of Recommendation.RESULTS(1)General characteristics:A total of 11 documents were included,comprising four clinical decision-making documents,two clinical guidelines,four expert consensus statements,and one systematic review.(2)Literature quality:The overall quality of the included studies was high.(3)Best evidence:A total of 23 pieces of evidence were summarized across nine aspects.The management approach begins by clearly defining the treatment objectives and establishing a dynamic monitoring baseline using both subjective and objective assessment tools while identifying controllable risk factors.A multidisciplinary resource integration strategy is then employed to develop stratified intervention plans,including optimization of basic pharmacological treatment,risk control in specific scenarios,tiered symptom management strategies,and precautions for iatrogenic procedures.Finally,a full-cycle health education system is implemented to reinforce management effectiveness,thereby enhancing the scientific rigor and efficacy of dry eye management in SS patients.The ultimate goal is to achieve both symptom control

关 键 词：干燥综合征 干眼 管理 循证护理 最佳证据总结 

分 类 号：R777.34[医药卫生—眼科]