糖尿病足评估的证据总结

A summary of evidence for diabetic foot assessment

目的检索、评价和总结糖尿病足评估的最佳证据,为规范我国糖尿病足评估的临床实践提供借鉴。方法计算机检索美国指南网、加拿大安大略注册护士协会、英国卫生保健机构、苏格兰校际间指南网、新英格兰指南小组、国际指南协作网、美国疾病预防控制中心、世界造口治疗师协会、伤口造口失禁护士协会、国际糖尿病足工作小组、美国创伤愈合学会、美国糖尿病协会、美国血管外科协会、中华医学会内分泌学分会、Clinical evidence、PubMed、ProQuest、Web of Science、Clinical Key、CINAHL、Best Practice、CNKI、VIP、Wanfang Data、医脉通中2010年1月—2018年7月间关于糖尿病足评估的所有循证临床实践指南和系统评价。由2名研究者对文献质量进行评价和资料提取,对符合质量标准的文献进行证据提取。结果共纳入7篇文献,其中指南6篇,系统评价1篇。经过分析,总结得出9类共32条关于糖尿病足评估内容的最佳证据。结论本研究总结了糖尿病足评估的最佳证据,为医疗机构完善糖尿病足的评估的临床实践提供了循证依据,证据引入临床时还需评估特定临床情境、考虑患者意愿及价值观,有针对性的选择证据。

Objective To search, appraise and summarize the best evidence of the diabetic foot assessment and provide a reference for the standardization of the clinical diabetic foot evaluation in China. Methods On the computer, the following websites as well as databases were searched: National Guideline Clearinghouse (NGC) of the USA, Registered Nurses' Association of Ontario (RNAO), National Institute for Health and Care Excellence (NICE) of UK, the Scottish Intercollegiate Guidelines Network (SIGN), New England Guidelines Group (NEGG), International Guidelines Network (IGN), American Center for Disease Control and Prevention (ACDC), World Council of Enterostomal therapists (WCET), Wound Ostomy Continence Nurses Society (WOCN), the International Working Group on Diabetic Foot (IWGDF), American Society for Wound Healing, American Diabetes Association (ADA), American Society for Vascular Surgery (ASVS), Society of Endocrinology of Chinese Medical Association, Clinical evidence, PubMed, ProQuest, Web of Science, Clinical Key, CINAHL, Best Practice, CNKI, VIP, Wanfang Data, Medlive from January of 2010 to July of 2018 about all evidence-based clinical practice guidelines and systematic reviews on assessment of diabetic foot. Two researchers evaluated the quality of the articles and performed materials extraction, and extracted the evidence from the qualified articles. Results A total of 7 articles were included among which 6 were guidelines and 1 was systemic review. After analyzing them, 9 categories and 32 items of the best evidence contents about diabetic foot assessment were concluded. Conclusions This study summarizes the best evidence for assessment of diabetic foot and provide evidence basis for medical institutions to improve clinical practice of diabetic foot assessment. When applying the evidence into clinical practice, it is necessary to evaluate specific situations, consider patients' values and willingness and select targeted evidence accordingly.