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护理学报 ›› 2024, Vol. 31 ›› Issue (18): 39-44.doi: 10.16460/j.issn1008-9969.2024.18.039

• 循证护理 • 上一篇    下一篇

胆汁淤积患者皮肤瘙痒管理的最佳证据总结

曹春菊1a, 王文1b, 黄梅英1c, 韩冰1c, 曾梅1c, 罗文洁1c, 张小琴2, 黄炜铃1c, 李文英1c, 苏韵涛1c, 唐素娟1c   

  1. 1.广州医科大学附属清远医院（清远市人民医院）a.护理部;b.普外二区;c.普外一区;广东 清远 511518;
    2.清远职业技术学院,广东 清远 511510
  • 收稿日期:2024-04-11 出版日期:2024-09-25 发布日期:2024-10-08
  • 作者简介:曹春菊（1981-）,女,湖南永州人,硕士研究生,主任护师,硕士研究生导师,护理部副主任。
  • 基金资助:
    2022年广州医科大学附属清远医院（清远市人民医院）专项基金（QYRYCRC2023004）; 2021广东省教育科学规划课题（2021GXJK695）

Best evidence summary for management of pruritus in patients with cholestasis

CAO Chun-ju1a, WANG Wen1b, HUANG Mei-ying1c, HAN Bing1c, ZENG Mei1c, LUO Wen-jie1c, ZHANG Xiao-qin2, HUANG Wei-ling1c, LI Wen-ying1c, SU Yun-tao1c, TANG Su-juan1c   

  1. 1a. Dept. of Nursing Administration; 1b. Dept. of General Surgery II; 1c Dept. of General Surgery I, Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China;
    2. Qingyuan Polytechnic, Qingyuan 511510, China
  • Received:2024-04-11 Online:2024-09-25 Published:2024-10-08

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摘要： 目的 评价并整合胆汁淤积患者皮肤瘙痒管理的相关证据,为胆汁淤积所致皮肤瘙痒患者的临床护理实践提供参考依据。方法 针对胆汁淤积患者皮肤瘙痒问题,进行国内外证据检索,包括临床决策、指南、专家共识、证据总结、系统评价。2名具有循证医学专业背景的研究者对文献质量进行独立评价和证据级别评定,并提取相关证据。结果 共纳入文献18篇,包括4篇临床决策、2篇指南、2篇证据总结、6篇系统评价和4篇专家共识,总结归纳出瘙痒评估、瘙痒病因处理、皮肤护理、局部治疗、全身用药、手术治疗、辅助治疗、心理护理8个方面,共23条最佳证据,形成了胆汁淤积患者皮肤瘙痒管理方案。结论 医护人员在临床实践中可结合目前最佳证据和患者价值观,制定个性化的治疗计划,以提高患者生活质量。

关键词: 胆汁淤积, 皮肤瘙痒, 循证护理

Abstract: Objective To evaluate and summarize the best evidence for the management of pruritus in patients with cholestasis, and to provide reference for clinical nursing practice in the treatment of pruritus caused by cholestasis. Methods An evidence-based nursing approach and the "5S" evidence model were employed to search for relevant evidence on the management of pruritus in cholestatic patients, including clinical decision-making, guidelines, expert consensus, evidence summaries, and systematic reviews from both domestic and international sources. Two researchers with background in evidence-based medicine independently assessed the quality of the literature and rated the evidence level, extracting the evidence meeting the criteria. Results A total of 18 articles were collected, including 4 clinical decision-makings, 2 guidelines, 2 evidence summaries, 6 systematic reviews, and 4 expert consensuses. Twenty-three pieces of best evidence were summarized into eight areas: pruritus assessment, management of pruritus etiology, skin care, topical treatments, systemic medications, surgical treatments, adjunctive therapies, and psychological interventions. A management protocol for pruritus in cholestatic patients was developed. Conclusion In clinical practice, healthcare professionals should consider patient conditions and preferences to develop personalized treatment plans so as to improve the quality of life for patients.

Key words: cholestasis, pruritus, evidence-based nursing

中图分类号: 

  • R473.57
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