慢性阻塞性肺疾病病人吸入治疗管理的最佳证据总结

Summary of best evidence for the management of inhalation therapy in patients with chronic obstructive pulmonary disease

目的:总结慢性阻塞性肺疾病病人吸入治疗管理最佳证据,为临床医护人员及居家慢性阻塞性肺疾病病人吸入治疗提供科学依据。方法:检索与慢性阻塞性肺疾病吸入治疗相关的指南、专家共识或专家意见、证据总结、系统评价,然后由经过循证课程培训的研究人员对纳入的文献进行质量评价,根据专业知识判断提取和整合证据,形成最佳证据总结。结果:最终纳入指南10篇,专家共识7篇,证据总结1篇,共18篇文献,从吸入剂装置的选择、吸入剂药物选择、吸入剂治疗后管理、雾化吸入方式的选择、雾化吸入药物指导、雾化吸入过程中管理、无创通气与雾化之间的影响、雾化吸入后管理8个方面形成了33条最佳证据。结论:慢性阻塞性肺疾病病人吸入治疗管理的最佳证据为临床正确实施雾化吸入操作的医护人员和病人及其照护者提供了循证依据。

Objective:To summarize the best evidence on inhalation therapy management of patients with chronic obstructive pulmonary disease(COPD)and provide a scientific basis for clinical medical staff and COPD patients who underwent home-based inhalation therapy.Methods:Relevant literature,including guidelines,expert consensus or expert opinion,evidence summary,and systematic review on inhalation therapy of COPD patients,were retrieved from databases.Researchers who were trained in evidence-based courses conducted a quality evaluation of the included literature.The evidence was extracted and integrated based on their professional knowledge to form the best evidence summary.Results:A total of 18 articles,including 10 guidelines,7 expert consensus articles,and 1 evidence summary,were finally included.A total of 33 pieces of best evidence were summarized from 8 aspects:the selection of inhalant devices,the selection of inhalant drugs,post-inhalant therapy management,the selection of atomized inhalation methods,aerosolization inhaled drug guidance,management during aerosol inhalation,the impact between non-invasive ventilation and atomization,and management after aerosol inhalation.Conclusions:The formed best evidence for inhalation therapy management in COPD patients provides an evidence-based basis for the correct clinical implementation of aerosol inhalation procedures and the correct use of inhalation therapy for patients and their caregivers.