护理学报 ›› 2024, Vol. 31 ›› Issue (23): 73-78.doi: 10.16460/j.issn1008-9969.2024.23.073
• 循证护理 • 上一篇
张星星1, 李瑞华1,2, 朱木兰1, 林梅燕1,2, 李雅男1, 龚立红1, 曾海婷1, 甄莉1
ZHANG Xing-xing1, LI Rui-hua1,2, ZHU Mu-lan1, LIN Mei-yan1,2, LI Ya-nan1, GONG Li-hong1, ZENG Hai-ting1, ZHEN Li1
摘要: 目的 整合国内外成人肠造口患者高排量预防与管理的最佳证据,为临床实践提供循证依据。方法 系统检索从建库至2023年12月31日决策支持系统、指南网站、数据库、专业机构网站中关于成人肠造口患者高排量预防与管理的证据,由2名研究者对符合标准的研究进行质量评价、证据提取及汇总。结果 共纳入14篇文献,其中临床决策支持1篇、指南4篇、证据总结2篇、系统评价3篇、专家共识2篇、随机对照研究2篇,总结了诊断与风险、饮食管理、药物干预、健康教育、造口管理、监测与随访6个方面的22条成人肠造口患者高排量预防与管理的最佳证据。结论 本研究针对成人肠造口患者高排量预防与管理进行证据总结,可为临床实践提供循证依据,具有一定的科学性和实用性。
中图分类号:
[1] Borucki JP, Schlaeger S, Crane J, et al.Risk and consequences of dehydration following colorectal cancer resection with diverting ileostomy. A systematic review and Meta-analysis[J].Colorectal Dis,2021,23(7):1721-1732.DOI:10.1111/codi.15654. [2] 赵泽英,邓颖辉,丁妮,等. 肠造口高排量的研究进展[J].护理研究,2020, 34(2):291-294.DOI:10.12102/j.issn.1009-6493.2020.02.022. [3] Arenas VJ, Lopez-Rodriguez C, Abiles J, et al.Protocol for the detection and nutritional management of high-output stomas[J]. Nutr J,2015(14): 45.DOI:10.1186/s12937-015-0034-z. [4] Nightingale J.How to manage a high-output stoma[J].Frontline Gastroenterol, 2022, 13(2):140-151.DOI:10.1136/flgastro-2018-101108. [5] 朱政,胡雁,邢唯杰,等. 不同类型循证问题的构成[J]. 护士进修杂志,2017,32(21):1991-1994.DOI:10.16821/j.cnki.hsjx.2017.21.025. [6] Alper BS, Haynes RB.EBHC pyramid 5.0 for accessing preappraised evidence and guidance[J]. Evid Based Med,2016,21(4):123-125.DOI:10.1136/ebmed-2016-110447. [7] Brouwers MC, Kerkvliet K,Spithoff K.The AGREE reporting checklist: a tool to improve reporting of clinical practice guidelines[J].BMJ,2016(352):i1152.DOI:10.1136/bmj.i1152. [8] 王磊,闫媛媛,赵晓艳,等. 造口治疗师护理角色与实践的最佳证据总结[J]. 护理研究, 2022, 36(12):2086-2092.DOI:10.12102/j.issn.1009-6493.2022.12.004. [9] JBI. JBI Critical Appraisal Tools[EB/OL].[2024-04-19]. https://jbi.global/critical-appraisal-tools. [10] 李丹阳,庄嘉元,林华燕,等. 临时性肠造口患者健康教育的最佳证据总结[J].中华护理杂志,2024,59(12):1454-1461.DOI:10.3761/j.issn.0254-1769.2024.12.007. [11] 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. [12] Landmann R,Cashman A. Ileostomy or colostomy care and complications[EB/OL].(2024-01-02)[2024-06-25].https://sso.uptodate.com/contents/ileostomy-or-colostomy-care-and-complications. [13] Registered Nurses’ Association of Ontario. Supporting adults who anticipate or live with an ostomy:second edition[EB/OL].[2021-11-16].https://rnao.ca/bpg/guidelines/ostomy. [14] Prinz A,Colwell JC,Cross HH,et al.Discharge planning for a patient with a new ostomy[J]. J Wound Ostomy Continence Nurs,2015,42(1):79-82.DOI:10.1097/WON. 0000000000000094. [15] Wound, Ostomy and Continence Nurses Society, Guideline Development Task Force. WOCN society clinical guideline: management of the adult patient with a decal or urinary ostomy-an executive summary[J]. J Wound Ostomy Continence Nurs,2018,45(1):50-58. DOI:10.1097/WON.0000000000000396. [16] Miller D, Pearsall E, Johnston D, et al.Executive summary: enhanced recovery after surgery: best practice guideline for care of patients with a fecal diversion[J]. J Wound Ostomy Continence Nurs,2017,44(1):74-77.DOI:10.1097/WON.0000000000000297. [17] Bronwyn OD. Evidence summary. Ileostomy (acute renal failure prvention): oral hydration solution[DB/OL].(2022-03-18)[2024-09-22].http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS=N&AN=JBI114960. [18] Minooee S.Evidence summary. Stoma care: post-operative patient assessment and education[DB/OL].(2023-06-14)[2024-09-22].https://ovidsp.dc2.ovid.com/ovid-b/ovidweb.cgi?&S=EHGNFPDJHNEBJEEAIPNJLELEAJHBAA00&SELECT=S.sh%7c&R=2&Process+Action=display. [19] De Vries FEE, Reeskamp LF, van Ruler O,et al. Systematic review: pharmacotherapy for high-output enterostomies or enteral fistulas[J]. Aliment Pharmacol Ther, 2017,46(3):266-273.DOI:10.1111/apt.14136. [20] Lederhuber H,Massey LH,Kantola VE,et al.Clinical management of high-output stoma: a systematic literature review and Meta-analysis[J]. Tech Coloproctol,2023,27(12):1139-1154.DOI:10.1007/s10151-023-02830-1. [21] 沈圆娟,戴正香,李菊云,等. 成人高排量回肠造口发生率及影响因素的meta分析[J].中华全科医学, 2023,21(2):324-328.DOI:10.16766/j.cnki.issn.1674-4152.002874. [22] Ratliff CR,Goldberg M,Jaszarowski K,et al.Peristomal skin health a WOCN society consensus[J]. J Wound Ostomy Continence Nurs,2021, 3(48):219-231.DOI:10.1097/WON. 0000000000000758. [23] Colwell JC, Ratliff CR, Goldberg M, et al.MASD part 3: peristomal moisture-associated dermatitis and periwound moisture-associated dermatitis: a consensus[J]. J Wound Ostomy Continence Nurs,2011,38(5):541-555.DOI:10.1097/WON.0b013e31822acd95. [24] Kristensen K, Qvist N.The acute effect of loperamide on ileostomy output: a randomized, double-blinded, placebo-controlled, crossover study[J]. Basic Clin Pharmacol Toxicol,2017,121(6):493-498.DOI:10.1111/bcpt.12830. [25] Venishetty N, Bansal S,Maheshwari G,et al.A randomized controlled trial to study the effects of loperamide on the fluid and electrolyte balance in patients undergoing an ileostomy[J].Indian J Surg,2021,83(5):1216-1222.DOI:10.1007/s12262-020-02647-4. [26] Zhang Q,Sun J,Wang D,et al.Knowledge, attitudes, practices and associated factors regarding high output stoma of ileostomy among colorectal surgical nurses: a multicentre cross-sectional study[J]. Support Care Cancer,2023,32(1):12.DOI:10.1007/s00520-023-08228-x. [27] Murken DR, Bleier J.Ostomy-related complications[J]. Clin Colon Rectal Surg,2019, 32(3):176-182.DOI:10.1055/s-0038-1676995. [28] 陈影,程帆. 造口高排量监测及风险评估研究进展[J]. 护理研究,2022,36(13):2353-2355.DOI:10.12102/j.issn.1009-6493.2022.13.017. [29] Santamaria MM,Villafranca J,Abiles J,et al.Impact of a nutrition consultation on the rate of high output stoma-related readmission: an ambispective cohort study[J]. Sci Rep,2021,11(1):16620.DOI:10.1038/s41598-021-96136-7. [30] 刘莺歌,吴燕,曹秋君,等.肠造口周围潮湿相关性皮肤损伤风险预测模型的构建及应用[J].中华护理杂志,2021,56(11):1612-1617.DOI:10.3761/j.issn.0254-1769.2021.11.002. [31] Culkin A,Gabe SM,Nightingale J.A new palatable oral rehydration solution: a randomised controlled cross-over study in patients with a high output stoma[J]. J Hum Nutr Diet,2022,35(1):94-101.DOI:10.1111/jhn.12935. [32] 宋思梦,李杨,初丽丽,等. 高流量造口患者营养管理策略的研究进展[J].护理学报,2024,31(1):42-45.DOI:10.16460/j.issn1008-9969.2024.01.042. [33] Rao VS, Sugunendran S,Issa E,et al.Metformin as a cause of high stomal output[J]. Colorectal Dis, 2012,14(2):e77.DOI:10.1111/j.1463-1318.2011.02667.x. [34] Messaris E, Sehgal R, Deiling S, et al.Dehydration is the most common indication for readmission after diverting ileostomy creation[J]. Dis Colon Rectum,2012,55(2):175-180.DOI:10.1097/DCR.0b013e31823d0ec5. [35] 李牧玲,甄莉,朱木兰,等. 肠造口患者造口周围潮湿相关性皮肤损伤预防及护理的最佳证据总结[J]. 护理学报,2023,30(1):41-46.DOI:10.16460/j.issn1008-9969.2023.01.041. [36] 杨芙鑫,王飞霞,钟紫凤,等. 高排量回肠造口护理管理及路径建设进展[J].护理与康复,2022,21(11):94-97.DOI:10.3969/j.issn.1671-9875.2022.11.025. |
[1] | 张静, 彭焕椽, 陈佳, 鲁永锦, 刘克玄, 侯晓敏. 成人体外循环心脏手术患者预防手术部位感染的最佳证据总结[J]. 护理学报, 2025, 32(4): 41-47. |
[2] | 刘璐, 朱钰, 曹义, 张华, 彭玉娜. 腹腔热灌注化疗患者术中实施不同目标体温管理的效果观察[J]. 护理学报, 2025, 32(4): 59-63. |
[3] | 李疆伟, 王树君, 李长仔, 胡宝山, 焦桂梅, 张卫红. 基于压力应对理论的护理干预对结直肠癌术后永久性肠造口患者心理压力、负性情绪及自我管理的影响[J]. 护理学报, 2025, 32(4): 64-69. |
[4] | 马小兰, 徐维昉. 基于症状管理理论的冰水喷雾对胸腔镜下肺叶切除术口渴患者的应用效果[J]. 护理学报, 2025, 32(4): 70-73. |
[5] | 吴超瑜, 刘尚昆. 麻醉恢复室护士危机管理能力的质性研究[J]. 护理学报, 2025, 32(3): 17-21. |
[6] | 李若雨, 刘鑫, 林萍, 陈丹, 林桦. 出院患者用药安全管理的最佳证据总结[J]. 护理学报, 2025, 32(3): 50-55. |
[7] | 杨蓓, 叶红芳, 张宁, 相卢伟, 路诗雨. 老年2型糖尿病患者体力活动现状及影响因素研究[J]. 护理学报, 2025, 32(2): 7-12. |
[8] | 朱天顺, 朱可可, 薛会元, 焦聪聪, 魏长慧, 王贺. 信息框架效应理论在健康管理领域应用的范围综述[J]. 护理学报, 2025, 32(2): 44-49. |
[9] | 陈燕华, 冯梅, 胡佩欣. 粤港联合个案管理师临床实践培训体验的质性研究[J]. 护理学报, 2025, 32(1): 24-28. |
[10] | 毕雅昕, 端烨, 何丽君, 徐秒, 龚荣花. 减重代谢术后骨质疏松症预防与管理的最佳证据总结[J]. 护理学报, 2025, 32(1): 44-49. |
[11] | 全伊萍, 陈霞, 胡琼丹. 脑心健康管理师核心胜任力评价指标体系的构建[J]. 护理学报, 2024, 31(9): 5-9. |
[12] | 叶香, 黎楷, 黄敏, 张倩, 李际敏, 刘荣珍, 孟敏, 朱少玉, 谢翠华. 对成年2型糖尿病患者基于移动APP+家属共管血糖的研究[J]. 护理学报, 2024, 31(9): 60-65. |
[13] | 郑桃花, 高翔, 康梅, 魏海霞, 柳笑, 张丽. 4R危机管理理论在结肠镜围检查期低血糖风险管理中的应用[J]. 护理学报, 2024, 31(7): 22-26. |
[14] | 倪乐凤, 刘林, 沈春华, 乔瑶, 周亮, 朱强, 龚卫娟. 输血护理时限管理相关指南的质量评价及内容分析[J]. 护理学报, 2024, 31(7): 51-56. |
[15] | 李爱群, 李利花, 王芳, 蒋源元, 蔡益民. 慢性病资源利用在冠心病PCI术后患者自我超越与自我管理行为间的中介效应[J]. 护理学报, 2024, 31(6): 13-17. |
|