恶性肿墙护理专题Topical Issues化疗相关性恶心呕吐风险评估的证据总结刘佳惠胡美华邓诗佳戚熠李旭英张清慧李金花[撕要】目的：全面检索、汇总并分析化疗相关性恶心呕吐(CINV)风险评估的证据。方法：计算机检索临床决策网站、指南网站、专业协会网站，循证文献资源库以及原始文献数据库中有关国内外CINV风险评估的临床决策，指南、专家共识、证据总结、系统评价等，并对符合纳人标准的文献进行方法学质量评价，结合专业判断、临床情境提取证据并进行汇总。结果：共纳人22篇文献，其中临床决策5篇，指南8篇，专家共识4篇，系统评价5篇。从症状评估、风险因素、评估时机、评估工具与评估者5个方面共汇总了12条证据。结论：证据总结为医疗机构建立CNV风险评估制度、流程和实践标准，规范开展CNV风险评估提供了循证依据。医护人员应结合临床情境和专业判断，合理地应用证据，以精准评估其相关风险。[关健词】化疗相关性恶心呕吐，风险因素，评估，证据总结[中图分类号]R47;R197D0川10.3969.issn.1672-1756.2023.03.015Evidence summary for the assessment of risk for Chemotherapy-Induced Nausea and Vomiting /LTU Jiahui,HU Meihua,DENG Shijia,OI Y,LI Xiying,ZHANG Oinghui,LI finhua N Department of Breast Medicine,Hunan Cancer Hoepital,Changsha,410003,China[Abatraet Objective:To comprehensively search,summarize,and analyze summaries of the best evidence forrisk assessment of Chemotherapy-Induced Nausea and Vomiting.Methods:Computerized systematic searches of clinicaldecision websites,major guideline websites,professional association websites,evidence-based literature repositories,andmajor literature databases for clinical decisions,guidelines,expert consensus,evidence summaries,and systematic reviewson Chemotherapy-Induced Nausea and Vomiting and risk factor assessment in China and abroad were conducted,andmethodological quality evaluations were performed and summarized to extract evidence with professional judgment andclinical context.Results:A total of 22 papers were included,including 5 clinical decisions,8 guidelines,4 expert consensus,and 5 systematic reviews.A total of 12 pieces of evidence were summarized from 5 directions:symptom assessment,riskfactors,assessmenttiming,assessment tools and assessors.Conchsion:Evidence summaries provide anevidence-based basisfor improving the accuracy of risk assessment for Chemotherapy-Induced Nausea and Vomiting,and healthcare providersshould establish a Chemotherapy-Induced Nausea and Vomiting risk assessment form,assessment process,and practicestandards Healthcare professionals should apply the evidence in a rational manner,tak ing into account clinical situations andprofessional judgment,in order to accurately assess their associated risksKeyword]Chemotherapy-Induced Nausea and Vomiting;risk factor,assessment;evidence summary化疗是癌症治疗计划的核心组降低其生活质量，增加医疗费用A。为临床精准评估化疗患者CINV的成部分，但由于化疗的细胞毒性作精准评估CNV的发生风险是预防发生风险提供指导。用，化疗后患者可能会发生许多不良CINV发生的前提。多项指南也建1资料与方法反应，如恶心、呕吐、疲乏与脱发议，应早期对化疗患者的CNV进1.1确立问题等。证据表明，化疗相关性恶心呕吐行风险因素评估。目前现有的采用复旦大学循证护理中心的(Chemotherapy--Induced Nausea指南、专家共识缺乏针对化疗患者问题开发工具一PIPOST模式，and Vomiting,CINV)是接受化CINV风险因素筛查、评估工具选形成结构化循证问题。目标人群：疗的患者最常见的不良反应冈，发生择及具体应用时机等方面的指引细接受化疗的成年肿瘤患者；干预方率可高达60%~80%。不受控制或则，临床上常用的CINV评估表以法：涉及化疗前后CINV风险因素控制不良的CNV会导致患者营养各医院自制为主，循证资源利用不足。筛查与评估有关的措施：应用证据不良、脱水和电解质失衡，影响治因此，本研究系统检索国内外有关的专业人员：护士和医生；结局：疗，也会干扰患者对化疗的依从性，CNV风险评估的证据并进行总结，CINV的发生率、CINV的严重程度基金项目：湖南省卫生健康委员会2020年度科研立项课题(20201632)，2021年度湖南省卫生健康委员会科研立项课题(202114011259)作者单位，湘雅循证实践与健康创新中心：JB协作组，湖南省肿瘤医院乳腺内科，410003长沙市(刘佳惠)，护理部（胡美华，李旭英，张清慧，李金花），胸部故疗科（邓诗佳），肝胆肠外科（戚烟）第一作着：刘佳惠，硕士，护师温信作者，胡美华，硕士，主任护师，科护
