口服糖皮质激素的非糖尿病化疗病人血糖管理的证据总结.

董元鸽; 张晓菊; 陈凤珍; 杨瑒; 汪洋; 郭小璐

To retrieve and analyze the best evidence of glycemic management in patients with non diabetic chemotherapy undergoing oral glucocorticoids, and to summarize and evaluate the evidence. Methods: The guidelines, evidence summaries, recommended practices, systematic evaluations and expert consensuses on glycemic control in patients with non diabetic chemotherapy undergoing oral glucocorticoids were retrieved from Cochrane Library,JBI Evidence Based Health Care International Cooperation Center Library, US Guide Network (NGC),Scottish Inter Academic Guide Network (SIGN), New Zealand Guideline Collaboration Group, PubMed,NICE, NCCN,ONS,RNAO, Wanfang Database and Chinese biomedical literature database (CBM), from the establishment of the library to July 2017. Two evidence based researchers evaluated the quality of the literature and extracted the data,and extracted evidence from the documents that met the quality standards. Results: A total of 3 articles were included, involving Z evidence summaries and 1 systematic review. After evaluation, the evidence of glycemic management in patients with non diabetic chemotherapy undergoing oral glucocorticoids were summarized: (1) Health care personnel should be aware of that patients with chemotherapy undergoing oral glucocorticoids had a risk of developing hyperglycemia (Class B recommendation); (2)Medical staff should inform patients a bout the symptoms and risks of hyperglycemia (Class B recommendation); (3) Health care providers should screen and monitor blood glucose in patients with glucocorticoids (Class B recommendation) ; (4)Identify and treat hyperglycemia by medical staff through multi disciplinary intervention consensus (Class B recommendation); (5) Health care professionals should educate patients with blood glucose ≥7. 8 mmol/L through dietary adjustment to control sugar intake (Class B recommendation); (6) Health care professionals should know twice monitoring of blood glucose in the afternoon and evening was more indicative than fasting blood glucose in blood glucose metabolism among non diabetic patients (Class B recommendation). Conclusions: Nursing staff could follow the evidence based medical evidences to regulate the management status of clinical blood glucose monitoring and provide a reference for providing the best evidence for clinical and formulating the monitoring process of high glucose induced by high dose glucocorticoids.

BLOOD sugar monitoring; CANCER chemotherapy; GLUCOCORTICOIDS; HYPERGLYCEMIA; INFORMATION storage & retrieval systems; MEDICAL databases; MEDLINE; ONLINE information services; DATA analysis; EVIDENCE-based nursing; GLYCEMIC control

Chinese Nursing Research, 2019, Vol 33, Issue 9, p1457

1009-6493

Academic Journal

10.12102/j.issn.1009-6493.2019.09.001