脑卒中后偏瘫性肩痛预防及管理的最佳证据总结

目的 系统检索并筛选脑卒中后偏瘫性肩痛管理的系列证据,并对最佳证据进行总结。方法 检索PubMed、JBI、CENTRAL、CINAHL、RNAO、Cochrane Library、NGC、NICE、SIGN、中国生物医学文献数据库、中国知网、万方、维普关于脑卒中后偏瘫性肩痛管理的相关证据,包括指南、专家共识、证据总结、系统评价,检索时限为2014年1月1日—2019年11月25日。由2名研究者对纳入的文献进行质量评价并交叉核对,有争议交由第3方进行裁决,对符合纳入排除标准的文献进行证据提取。结果 本研究共纳入证据11篇,包括指南4篇,专家共识1篇,系统评价6篇,从健康教育、肩部评估、躯体活动、药物治疗、辅助治疗5个方面进行了证据汇总,形成了21条最佳证据。结论 临床医护人员在应用此项证据时应审慎结合所在医疗机构临床环境、患者意愿等因素,从而进行针对性的证据应用。同时,考虑证据的动态变化性,随着时间的推移,应用人员需要对证据进行持续的更新,筛查出最佳证据,以更为科学合理的手段解决脑卒中后偏瘫性肩痛问题,从而提升临床护理质量。

Best Evidence Summary of Prevention and Management of Hemiplegic Shoulder Pain in Stroke Patients

Objective To search and summarize the best evidence of prevention and management of hemiplegic shoulder pain in stroke patients.Methods We searched PubMed、JBI、CENTRAL、CINAHL、RNAO、Cochrane Library、NGC、NICE、SIGN、CBM、CNKI、Wangfang and VIP for guidelines,expert consensus,systematic review and recommended practice from 1 January in 2014 to 25 November in 2019.Two researchers evaluated the quality of the literature and conducted cross-checking.In case of any dispute,the third party was introduced to make a decision and evidence was extracted from the literature that met the inclusion and exclusion criteria.Results Eleven papers were included in this research,with four guidelines,one consensus and six systemic reviews.The evidence was summarized from 6 aspects of health education,shoulder evaluation,activity,drug treatment and adjuvant treatment,obtaining 21 best evidence.Conclusion Clinical environment,patients' wishes and other factors should be taken into consideration for targeted evidence application.Meanwhile,continuous update of the best evidence is beneficial to providing scientific methods for hemiplegic shoulder pain,so as to improve the quality of clinical nursing.