院外胰島素泵治療病人自我管理的最佳證據總結

Summary of the best evidence for self-management of patients receiving insulin pump therapy outside the hospital

LIU Jiaqiu，LING Hua，LI Yuxia，CHEN Ying，YU Ran，SUN Xiaoxuan，WANG XuxingThe First Affiliated Hospital of Nanchang University，Jiangxi 330006 ChinaCorresponding Author LING Hua，E-mail：251182749@qq.com

Abstract Objective：To search，evaluate，and summarize the relevant evidence on the self-management of patients receiving insulin pump therapy outside the hospital.Methods：The relevant literature on self-management of patients receiving insulin pump therapy outside the hospital was retrieved systematically from BMJ Best Practice，UpToDate，WHO Guidelines，American Diabetes Association，Yimaitong，the Endocrine Society，the Cochrane Library，PubMed，Web of Science，EMbase，CINAHL，CBM，CNKI，WanFang，and other domestic and foreign websites and databases.The search time limit was from establishing the database to October 31，2023.Two researchers evaluated the quality of the included literature and extracted evidence.Results：A total of 10 articles were included，including 5 guidelines，3 systematic reviews，1 randomized controlled study，and 1 expert consensus.A total of 26 pieces of best evidence were summarizes around 5 aspects：assessment，blood glucose monitoring，standardized injection，diet and exercise，and health education.Conclusions：The best evidence summarized for self-management of patients receiving insulin pump therapy outside the hospital could provide an evidence-based basis for clinical staff to optimize the self-management of patients receiving insulin pump therapy outside the hospital.

Keywords insulin pump;self-management;evidence summary;evidence-based nursing;home care

摘要 目的：檢索、評價及總結關于院外進行胰島素泵治療病人自我管理的相關證據。方法：系統檢索BMJ Best Practice、UpToDate、世界衛生組織指南網、美國糖尿病協會、醫脈通、內分泌學會、the Cochrane Library、PubMed、Web of Science、EMbase、CINAHL、中國生物醫學文獻數據庫、中國知網、萬方數據庫等國內外指南網站及數據庫中關于院外胰島素泵治療病人自我管理的相關文獻，檢索時限為建庫至2023年10月31日。由2名研究者對納入文獻進行質量評價及證據提取。結果：共納入10篇文獻，其中指南5篇、系統評價3篇、隨機對照研究1篇、專家共識1篇。圍繞評估、血糖監測、規范化注射、飲食與運動、健康教育5個方面，匯總26條最佳證據。結論：總結的院外胰島素泵治療病人自我管理的最佳證據可為臨床工作人員優化院外胰島素泵病人的自我管理提供循證依據。

關鍵詞 胰島素泵;自我管理;證據總結;循證護理;居家護理

doi：10.12102/j.issn.2095-8668.2024.13.004

2020年研究數據顯示，我國18歲以上糖尿病患病人數約1.3億，其中61.53%的病人需進行胰島素治療［1］。胰島素泵（continuous subcutaneous insulin infusion，CSII）是一種通過皮下組織連續注射胰島素的裝置，可最大限度地模擬生理性胰島素分泌模式的治療方法［2］。隨著醫學技術的進步，胰島素泵朝著人工胰腺的方向不斷發展，越來越多的病人在院外進行胰島素泵治療［3］。由于胰島素泵儀器精密，有效的自我管理行為對院外胰島素泵治療病人獨立完成胰島素輸注及輸注系統的長期維護至關重要，可維持血糖穩定，并能提高病人生活質量［4］。目前，國內外針對胰島素泵院外隨訪管理的研究內容較為零散、缺乏針對性及延續性，且尚未檢索到國內外完整的胰島素泵自我管理流程。……