维持性血液透析患者口干口渴管理的最佳证据总结

Summary of the best evidence for the xerostomia and thirst management in maintenance hemodialysis patients

目的检索、评价并汇总维持性血液透析(maintenance hemodialysis,MHD)患者口干口渴管理的相关证据,为临床医护人员缓解MHD患者口干口渴的症状提供循证依据。方法系统检索BMJ Best Practice、UpToDate、英国国家卫生与临床优化研究所网站、国际指南网、美国国立指南网、加拿大医学会临床实践指南网、医脉通等网站,以及Cochrane Library、澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、PubMed、Embase、CINAHL、中国知网、万方数据库、维普数据库、中国生物医学文献数据库等数据库中关于MHD患者口干口渴干预的证据,文献类型包括指南、专家共识、临床决策、最佳临床实践、证据总结、系统评价、随机对照试验。检索时限为2013年1月1日—2023年9月30日。结果最终纳入12篇文献,其中系统评价3篇、随机对照试验9篇。最佳证据包括评估、基础干预、口腔局部干预、中草药疗法、耳穴按压、中草药联合穴位疗法6个方面,共19条证据。结论该研究总结的最佳证据具有科学性和系统性,血液净化医护人员根据MHD患者和具体临床情境等进行综合考量,针对性的采取干预措施,以缓解MHD患者口干口渴症状,减轻身心痛苦,提高其生活质量。

Objective To search,evaluate and summarize the relevant evidence of management on xerostomia and thirst of maintenance hemodialysis(MHD)patients,and provide the evidence for clinical medical staff to relieve the symptoms of xerostomia and thirst in MHD patients.Methods We search guideline websites such as the BMJ Best Practice,UpToDate,NICE,GIN,NGC,CMA Infobase,Medlive,and databases such as Cochrane Library,JBI,PubMed,Embase,CINAHL,CNKI,Wanfang,VIP,SinoMed related to interventions on xerostomia and thirst of MHD patients.The literature types include guidelines,expert consensuses,clinical decisions,best practice,evidence summaries,systematic reviews,randomized controlled trials.The search period is from January 1,2013 to September 30,2023.Results A total 12 pieces of the literature were included,including 3 systematic reviews and 9 randomized controlled trials.A total of 19 pieces of evidence were summarized in 6 aspects,including evaluation,basic interventions,oral local interventions,auricular acupressure,dialysis scheme,Chinese herbal medicine combined with acupoint therapy and Chinese herbal medicine therapy.Conclusion Blood purification medical staff should comprehensively consider MHD patients and specific clinical situations,and make interventions to relieve the symptoms of xerostomia and thirst of MHD patients,relieve their physical and mental pain and improve their quality of life.