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护理学报 ›› 2022, Vol. 29 ›› Issue (18): 47-52.doi: 10.16460/j.issn1008-9969.2022.18.047

• 循证护理 • 上一篇    下一篇

肺移植术后出院患者并发症预防与管理的最佳证据总结

洪丽微1, 侯春怡1, 沈香香2, 张会锦1, 张清1, 巨春蓉1, 黄丹霞1   

  1. 1. 广州呼吸健康研究院 广州医科大学附属第一医院,广东 广州 510120;
    2. 广州医科大学 护理学院,广东 广州 510182
  • 收稿日期:2021-11-30 出版日期:2022-09-25 发布日期:2022-10-11
  • 通讯作者: 侯春怡（1973-）,女,广东广州人,本科学历,副主任护师,硕士研究生导师。E-mail：373769031@qq.com
  • 作者简介:洪丽微（1994-）,女,广东湛江人,本科学历,硕士研究生在读。
  • 基金资助:
    2021年广东省护士协会科研课题基金项目（gdshsxh2021a108）

Best Evidence Summary for Prevention and Management of Complication in Discharged Patients after Lung Transplantation

HONG Li-wei1, HOU Chun-yi1, SHEN Xiang-xiang2, ZHANG Hui-jin1, ZHANG Qing1, JU Chun-rong1, HUANG Dan-xia1   

  1. Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China;
    2. School of Nursing, Guangzhou Medical University, Guangzhou 510182, China
  • Received:2021-11-30 Online:2022-09-25 Published:2022-10-11

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摘要： 目的 检索和总结肺移植术后出院患者并发症预防与管理的最佳证据,为临床实践提供参考依据。方法 计算机系统检索PubMed、CINAHL、EMbase、UpToDate、BMJ Best Practice、JBI循证卫生保健中心数据库、Cochrane Library、中国知网和万方数据库等关于肺移植术后出院患者并发症的预防与管理的证据,包括指南、临床决策、系统评价、专家共识、证据总结,检索时限为建库至2022年8月。结果 共纳入12篇文献,包括临床决策1篇、指南1篇、系统评价5篇、专家共识5篇,从排斥反应、胃肠道并发症、新发糖尿病、心理健康相关并发症等4个方面共总结了25条最佳证据。结论 本研究总结了肺移植术后出院患者并发症预防与管理的最佳证据,肺移植相关工作者可根据患者临床具体情况,结合专业判断,形成有效、可行的并发症预防与管理策略,从而为患者提供科学的指导与管理。

关键词: 肺移植, 手术后并发症, 预防护理, 出院后医疗, 循证护理

Abstract: Objective To retrieve and summarize the best evidence of prevention and management of complications in discharged patients after lung transplantation, and to provide reference for clinical practice. Methods We searched PubMed, CINAHL, Embase, UpToDate, BMJ Best Practice, JBI EBP Database, Cochrane Library, CNKI and Wanfang Database for evidence of prevention and management of complications in discharged patients after lung transplantation, including the guideline, clinical decision, systematic evaluation, expert consensus and evidence summary. The retrieval period was from the inception of the databases to August 2022. Results Twelve articles were collected, including 1 clinical decision, 1 guideline, 5 systematic evaluations and 5 expert consensuses. Twenty-five pieces of best evidence were classified into 4 categories of rejection, gastrointestinal complication, new onset diabetes and psychological health. Conclusion The present study summarizes the best evidence of prevention and management of complications in discharged patients after lung transplantation. Effective and feasible prevention and management strategies could be proposed based on individual conditions and professional judgement.

Key words: lung transplantation, postoperative complication, preventive nursing, medical care after discharge, evidence-based nursing

中图分类号: 

  • R473.56
[1] Chambers DC, Perch M, Zuckermann A, et al.The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-eighth Adult Lung Transplantation Report—2021; Focus on Recipient Characteristics[J]. J Heart Lung Transplant, 2021,40(10):1060-1072. DOI: 10.1016/j.healun.2021.07.021.
[2] 杨航, 卫栋, 张稷, 等. 肺移植术后中心气道狭窄危险因素分析[J]. 器官移植, 2022,13(2):240-245. DOI: 10.3969/j.issn.1674-7445.2022.02.013.
[3] 程梦园, 张甜, 张海玲, 等. 基于CiteSpace的国内肺移植护理研究的可视化分析[J]. 护士进修杂志, 2022,37(4):344-347. DOI:10.16821/j.cnki.hsjx.2022.04.011.
[4] 肖漓, 解立新, 石炳毅. 肺移植免疫学相关基础与临床研究进展[J]. 器官移植, 2021,12(6):637-642. DOI:10.3969/j.issn.1674-7445.2021.06.001.
[5] 梁璟, 赵辰荷, 杨吟秋, 等. 不同器官移植后新发糖尿病发病率及其危险因素比较[J]. 中华内分泌代谢杂志, 2017,33(9):805-810.DOI:10.3760/cma.j.issn.1000-6699.2017.09.022.
[6] 彭复聪, 胡树菁, 刘红霞, 等. 肺移植受者真实体验的质性研究[J]. 解放军护理杂志, 2022,39(6):52-55. DOI:10.3969/j.issn.1008-9993.2022.06.013.
[7] 严浩吉, 陈蔚洋, 魏桢婷, 等. 肺移植术后胃肠道并发症的研究进展[J]. 器官移植, 2020,11(6):749-753. DOI:10.3969/j.issn.1674-7445.2020.06.016.
[8] Hirche TO, Knoop C, Hebestreit H, et al.Practical Guidelines: Lung Transplantation in Patients with Cystic Fibrosis[J]. Pulm Med, 2014,2014:621342. DOI: 10.1155/2014/621342.
[9] Shah P, Lowery E, Chaparro C, et al.Cystic Fibrosis Foundation Consensus Statements for the Care of Cystic Fibrosis Lung Transplant Recipients[J]. J Heart Lung Transplant, 2021,40(7):539-556. DOI: 10.1016/j.healun.2021.04.011.
[10] 郭健雄, 龚丽娴, 季波, 等. 新型冠状病毒肺炎疫情期间器官移植受者随访与免疫抑制方案调整建议[J]. 中国医院药学杂志, 2020,40(6):636-639. DOI:10.13286/j.1001-5213.2020.06.08.
[11] 李琳璨, 王海播, 杨豆, 等. 基于微信随访的自我管理对肺移植受者居家期间生活质量的影响[J]. 中西医结合护理(中英文),2019, 5(2):48-51.DOI:10.11997/nitcwm.201902012.
[12] Aromataris E, Fernandez R, Godfrey CM, et al.Summarizing Systematic Reviews: Methodological Development, Conduct and Reporting of an Umbrella Review Approach[J]. Int J Evid Based Healthc, 2015,13(3):132-140. DOI: 10.1097/XEB.0000000000000055.
[13] Dicenso A, Bayley L, Haynes RB.Accessing Pre-appraised Evidence: Fine-tuning the 5S Model into a 6S Model[J]. Evid Based Nurs, 2009,12(4):99-101. DOI: 10.1136/ebn.12.4.99-b.
[14] 周芬, 郝玉芳, 丛雪, 等. 指南研究与评价工具AGREE Ⅱ及各领域分值的补充解释及思考[J]. 护理学报, 2018,25(18):56-58. DOI:10.16460/j.issn1008-9969.2018.18.056.
[15] 顾莺, 张慧文, 周英凤, 等. JBI循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价[J]. 护士进修杂志, 2018,33(8):701-703. DOI: 10.16821/j.cnki.hsjx.2018.08.008.
[16] 卢舒颖, 杨阳, 刘宁. 0~5岁婴幼儿良好睡眠质量建立及管理的最佳证据总结[J]. 护理学报, 2022,29(12):45-50.DOI: 10.16460/j.issn1008-9969.2022.03.046.
[17] 胡雁, 郝玉芳, 李晓玲, 等. 循证护理学[M]. 2版.北京:人民卫生出版社, 2018.
[18] 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015,30(11):964-967. DOI: 10.16821/j.cnki.hsjx.2015.11.002.
[19] Seiler A, Klaghofer R, Ture M, et al.A Systematic Review of Health-related Quality of Life and Psychological Outcomes after Lung Transplantation[J]. J Heart Lung Transplant, 2016,35(2):195-202. DOI: 10.1016/j.healun.2015.07.003.
[20] Hu L, Lingler JH, Sereika SM, et al.Nonadherence to the Medical Regimen after Lung Transplantation: A Systematic Review[J]. Heart Lung, 2017,46(3):178-186. DOI:10.1016/j.hrtlng.2017.01.006.
[21] Saldanha IJ, Akinyede O, Robinson KA.Immunosuppressive Drug Therapy for Preventing Rejection Following Lung Transplantation in Cystic Fibrosis[J]. Cochrane Database Syst Rev,2018,6(6):D9421. DOI:10.1002/14651858.CD009421.pub4.
[22] Shahmoradi L, Abtahi H, Amini S, et al.Systematic Review of Using Medical Informatics in Lung Transplantation Studies[J]. Int J Med Inform, 2020(136):104096. DOI: 10.1016/j.ijmedinf.2020.104096.
[23] Stubber C, Kirkman M.The Experiences of Adult Heart, Lung, and Heart-lung Transplantation Recipients: A Systematic Review of Qualitative Research Evidence[J]. PLoS One,2020,15(11):e241570.DOI:10.1371/journal.pone.0241570.
[24] 周海琴, 朱雪芬, 黄琴红. 肺移植护理技术操作规范[J]. 实用器官移植电子杂志, 2019,7(5):340-342. DOI: 10.3969/j.issn.2095-5332.2019.05.005.
[25] 卫栋, 范立, 班乐. 中国肺移植术后并发症诊疗和随访技术规范(2019版)[J]. 中华移植杂志(电子版), 2019,13(2):99-108. DOI: 10.3877/cma.j.issn.1674-3903.2019.02.005.
[26] 吴波, 杨航. 中国肺移植免疫抑制治疗及排斥反应诊疗规范(2019版)[J]. 中华移植杂志(电子版), 2019,13(2):94-98. DOI:10.3877/cma.j.issn.1674-3903.2019.02.004.
[27] Crespo MM, Claridge T, Domsic RT,et al.ISHLT Consensus Document on Lung Transplantation in Patients with Connective Tissue Disease: Part III: Pharmacology, Medical and Surgical Management of Post-transplant Extrapulmonary Conditions Statements[J]. J Heart Lung Transplant, 2021,40(11):1279-1300.DOI:10.1016/j.healun.2021.07.013.
[28] Matthew GH, Jacob AK.肺移植程序与术后管理[EB/OL]. [2022-06-26].https://www.uptodate.com/contents/zh-Hans/lung-transplantation-procedure-and-postoperative-management.
[29] Burton CM, Iversen M, Mortensen J, et al.Post-transplant Baseline FEV1 and the Development of Bronchiolitis Obliterans Syndrome: An Important Confounder?[J]. J Heart Lung Transplant, 2007, 26(11):1127-1134.DOI:10.1016/j.healun.2007.07.041.
[30] Finkelstein SM, Snyder M, Stibbe CE, et al.Staging of Bronchiolitis Obliterans Syndrome using Home Spirometry[J]. Chest, 1999,116(1):120-126. DOI:10.1378/chest.116.1.120.
[31] 苏俊波, 骆文龙. 免疫抑制剂FK506在器官移植中应用的新进展[J]. 重庆医学, 2002,31(12):1259-1261. DOI: 10.3969/j.issn.1671-8348.2002.12.055.
[32] Graham BL, Steenbruggen I, Miller MR, et al.Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement[J]. Am J Respir Crit Care Med, 2019,200(8): e70-e88. DOI: 10.1164/rccm.201908-1590ST.
[33] 褚君卿, 高春华, 俞超, 等. 肺移植患者围手术期营养支持的研究进展[J]. 中华急危重症护理杂志, 2021,2(04):360-364. DOI:10.3761/j.issn.2096-7446.2021.04.016.
[34] Upala S, Panichsillapakit T, Wijarnpreecha K, et al.Underweight and Obesity Increase the Risk of Mortality after Lung Transplantation: A Systematic Review and Meta-analysis[J]. Transpl Int, 2016,29(3):285-296. DOI:10.1111/tri.12721.
[35] Fazekas-Lavu M, Reyes M, Malouf M, et al.High Prevalence of Diabetes before and after Lung Transplantation: Target for Improving Outcome?[J]. Intern Med J, 2018,48(8):916-924. DOI:10.1111/imj.13963.
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