肺癌患者免疫检查点抑制剂相关肺炎预防与管理的最佳证据总结

Prevention and management of checkpoint inhibitor pneumonia in patients with lung cancer:a summary of best evidence

目的评价和总结肺癌患者免疫检查点抑制剂相关肺炎(checkpoint inhibitor pneumonitis,CIP)预防与管理的最佳证据,为医护人员临床实践提供参考。方法运用JBI循证卫生保健中心的PIPOST模型构建循证问题,通过证据检索资源的“6S”分类模型对国内外相关指南网站、数据库及专业协会网站中有关肺癌患者CIP的预防与管理进行证据检索,筛选符合纳入标准的文献,并由2名经循证护理培训的研究员独立完成文献质量评价及证据提取。结果共纳入10篇文献,其中5篇指南,3篇系统评价,2篇专家共识。最佳证据包括CIP高危风险评估、预防教育、基线监测、早期识别和管理5个方面共30条证据。结论本研究汇总的预防与管理肺癌患者CIP最佳证据,可为医护人员提供循证依据。

Objective To evaluate and review the best evidence for the prevention and management of checkpoint inhibitor pneumonitis(CIP)in patients with lung cancer.Methods The PIPOST model of JBI Evidence-based Health Care Centre was used to construct evidence-based problems.Through the model of"6S"classification for evidence retrieval resources,evidence retrieval was conducted in the prevention and management of CIP through relevant websites for guidelines,databases and websites of professional associations in China and abroad.The documents that met the inclusion criteria were screened and selected.Two researchers trained in evidence-based nursing independently completed the literature quality evaluation and evidence extraction.Results A total of 10 papers were included,including 5 guidelines,3 systematic reviews and 2 expert consensus.The best evidence included 30 pieces of evidence from 5 aspects of CIP high-risk assessment,preventive education,baseline monitoring,early identification and management.Conclusions The best evidence of prevention and management of CIP in lung cancer patients summarized in this study provide evidence-based basis for medical staff.It is suggested that clinical medical staff should introduce and transform the evidence according to the clinical situations and the patient's wills,so as to improve the prevention and treatment ability and reduce the incidence of CIP as far as possible.