基于最佳证据的血液透析病人血糖管理指导流程图的构建

Construction of blood glucose management guidance flow chart for hemodialysis patients based on best evidence

目的:评价并总结血液透析病人血糖管理的相关证据,根据最佳证据构建血液透析病人血糖管理指导流程图,为临床指导血液透析病人血糖管理提供依据。方法:系统检索中国知网、万方、维普、BMJ Best Practice、UpToDate、EMbase、PubMed、Web of Science、the Cochrane Library等数据库中关于血液透析病人血糖管理的相关文献。检索时限为建库至2022年6月30日。对文献质量进行评价整合、证据分级;采用专家小组会议法构建血糖管理指导流程图。结果:最终纳入9篇文献,其中系统评价2篇,专家共识2篇,指南5篇。总结了包括血糖管理、血糖监测、血糖控制目标、用药干预、胰岛素控制5个方面、31条证据,并构建了血液透析病人血糖管理指导的流程图。结论:总结了血液透析病人血糖管理相关的最佳证据,并根据最佳证据制作了血糖管理指导流程图,可为医护人员临床指导血液透析病人血糖管理提供参考。

Objective:To evaluate and summarize the relevant evidence of blood glucose management in hemodialysis patients,and construct a blood glucose management guidance flow chart for hemodialysis patients based on the best evidence to provide a basis for clinical guidance of blood glucose management in hemodialysis patients.Methods:Relevant literatures on blood glucose management in hemodialysis patients were systematically searched in CNKI,Wanfang Data,VIP,BMJ,UpToDate,EMbase,PubMed,Web of Science,the Cochrane Library.The retrieval time was from the establishment of the database to June 30,2022.The quality of the literatures were evaluated and integrated,and the evidence was graded;the expert group meeting method was used to construct a blood glucose management guidance flow chart.Results:Finally,9 articles were included,including 2 systematic reviews,2 expert consensus articles,and 5 guidelines.A total of 31 pieces of evidence were summarized,including blood glucose management,blood glucose monitoring,blood glucose control goals,medication intervention,and insulin control.And a flow chart of blood glucose management guidance for hemodialysis patients was constructed.Conclusion:The best evidence related to blood glucose management in hemodialysis patients was summarized,and a blood glucose management guidance flow chart based on the best evidence was constructed,which can provide references for medical staff to guide blood glucose management in hemodialysis patients.