脑卒中患者口腔健康管理的最佳证据总结

目的 总结脑卒中患者口腔健康的最佳证据,为临床实践提供依据。方法 计算机检索BMJ Best Practice、美国国立指南库、加拿大安大略注册护士协会、国际指南协作网、苏格兰院际指南网、Cochrane Library、JBI循证卫生保健中心数据库、英国国家卫生与临床优化研究所、PubMed、中国知网、CBM、万方数据库的所有关于脑卒中患者口腔健康管理的证据,包括最佳实践信息册、临床决策、指南、系统评价、证据总结、专家共识,检索从建库至2021年6月8日。按照纳入排除标准进行筛选,由2名研究者进行独立评价,依据专家意见提取并综合证据。结果 共纳入10篇文献,其中8篇指南,2篇系统评价,从组织团队、培训教育、计划与评估、实施、特殊患者、健康宣教6个方面总结出20条脑卒中患者口腔健康管理的最佳证据。结论 临床实践中医务人员需加强口腔健康管理知识的教育培训,通过跨专业团队为患者制定口腔护理计划,动态评估患者口腔健康状况,把握口腔护理实施的时机和频率,为患者选择合适的口腔护理用具,加强特殊患者的口腔健康管理,为脑卒中患者及其照护者提供口腔健康信息支持。需结合具体临床判断及需求,有指向性地选择证据,以促进最佳证据在脑卒中患者口腔健康管理中的应用。

Best Evidence Summary of Oral Health Management for Stroke Patients

Objective To summarize the best evidence of oral health management for stroke patients, and provide reference for clinical practice. Methods We systematically searched websites of BMJ Best Practice, National Guideline Clearinghouse（NGC）, Registered Nurses Association of Ontario（RNAO）,Guidelines International Network（GIN）, Scottish Intercollegiate Guidelines Network（SIGN）, Cochrane Library, Joanna Briggs Institute（JBI）, National Institute for Health and Care Excellence（NICE）, PubMed, CNKI, CBM and Wanfang for best practice information, clinical decision support, guideline, systematic review, evidence summary, expert consensus from the inception to 8, June 2021. Screening was conducted according to the inclusion and exclusion criteria, and independent evaluation was conducted by two researchers. Evidence was extracted and synthesized according to expert opinions. Results Ten pieces of literature were collected, including 8 guidelines and 2 systematic reviews. Twenty pieces of best evidence of oral health management for stroke patients were summarized from 6 aspects of team organization, training and education, planning and evaluation, implementation, special patients and health education. Conclusion In clinical practice, medical staff need to strengthen the education and training of oral health management knowledge, Oral care plans for patients through a multi-professional team, dynamic evaluation of patients' oral health, the timing and frequency of oral care, appropriate oral care appliances for patients, oral health management of special patients, and oral health information support for stroke patients and their caregivers should be considered. Evidence should be selected according to specific clinical judgment and needs, so as to promote the application of the best evidence in oral health management of stroke patients.