肺癌手術(shù)病人出院準備服務的最佳證據(jù)總結(jié)

Summary of the best evidence for discharge preparation services for patients undergoing lung cancer surgery

JI Wenying，SHEN Yonghong，ZHANG Yan，PU Zhiyan，YAO RongYueyang Hospital of Integrated Traditional Chinese and Western Medicine，Shanghai University of Traditional Chinese Medicine，Shanghai 200437 China

Corresponding Author SHEN Yonghong，E-mail：shenyonghong728@163.com

Abstract Objective：To systematically search，evaluate，and summarize the best evidence for discharge preparation services for patients undergoing lung cancer surgery to provide a basis for clinical practice.Methods：Relevant literature of guidelines，evidence summaries，best practices，clinical decision-making，systematic reviews，standards，and expert consensus on discharge preparation services for patients undergoing lung cancer surgery was retrieved from UpToDate，BMJ Best Practice，JBI，NICE，NGC，the Cochrane Library，PubMed，Yimaitong，CNKI，SinoMed，WanFang Database，VIP，and other domestic and foreign websites and databases.The search period was from the establishment of the database to November 30，2023.The literature was evaluated according to the literature quality evaluation tool，and the evidence was extracted，summarized，and graded.Results：A total of 18 articles were included，including 3 clinical decision-making articles，4 guidelines，2 evidence summaries，4 systematic reviews，3 expert consensus articles，and 2 standards.Finally，the best evidence for discharge preparation services for lung cancer surgery patients was formed with 28 recommendations on 5 topics，including admission assessment，discharge plan formulation，discharge preparation，discharge follow-up，and effect evaluation.Conclusions：When applying the summarized evidence，clinical medical staff need to combine the national conditions，department characteristics，and actual patient conditions to develop a localized and personalized discharge preparation service plan for patients undergoing lung cancer surgery to improve the patients discharge readiness and reduce the patients postoperative complications and readmission rate effectively.

Keywords lung cancer;thoracoscopy;discharge preparation;evidence summary;evidence-based nursing

摘要 目的：系統(tǒng)檢索、評價、總結(jié)肺癌手術(shù)病人出院準備服務的最佳證據(jù)，為臨床實踐提供依據(jù)。方法：系統(tǒng)檢索UpToDate、BMJ Best Practice、JBI、NICE、NGC、the Cochrane Library、PubMed、醫(yī)脈通、中國知網(wǎng)、中國生物醫(yī)學文獻服務系統(tǒng)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫等國內(nèi)外網(wǎng)站及數(shù)據(jù)庫中關(guān)于肺癌手術(shù)病人出院準備服務相關(guān)指南、證據(jù)總結(jié)、最佳實踐、臨床決策、系統(tǒng)評價、標準、專家共識，檢索時限為建庫至2023年11月30日。依據(jù)文獻質(zhì)量評價工具評價文獻，對證據(jù)進行提取、匯總和分級。結(jié)果：共納入18篇文獻，其中臨床決策3篇、指南4篇、證據(jù)總結(jié)2篇、系統(tǒng)評價4篇、專家共識3篇、標準2篇，最終形成入院篩查評估、制定出院計劃、出院準備、出院后續(xù)追蹤、效果評價5個主題共28條推薦意見的肺癌手術(shù)病人出院準備服務最佳證據(jù)。結(jié)論：臨床醫(yī)護人員在應用總結(jié)的證據(jù)時，需結(jié)合本國國情、科室特點及病人實際情況，制定本土化、個性化的肺癌手術(shù)病人出院準備服務方案，以提高病人出院準備度，有效減少病人術(shù)后并發(fā)癥及再入院率。

關(guān)鍵詞 肺癌;胸腔鏡;出院準備;證據(jù)總結(jié);循證護理

doi：10.12102/j.issn.2095-8668.2024.13.001

肺癌是全球高發(fā)病率和高死亡率的惡性腫瘤［1］，手術(shù)是目前最有效的治療手段［2］。手術(shù)切除腫瘤的同時，也會導致肺損傷、肌力下降［3］，病人術(shù)后常面臨各種并發(fā)癥和較高的癥狀負擔，包括呼吸急促、疲勞、咳嗽、疼痛、睡眠障礙等，對其生活質(zhì)量產(chǎn)生負面影響［4］。隨著醫(yī)療技術(shù)的不斷提高和治療的日益規(guī)范化，病床的利用率和周轉(zhuǎn)率隨之提高［5］。早期出院雖然可以減少病人住院費用，加快床位周轉(zhuǎn)率，但會導致病人在院學習相關(guān)疾病知識和康復技能的時間減少。……