帕金森病患者吞咽障碍评估及管理的最佳证据总结 [中文引用][英文引用]

目的  检索、评价并总结国内外有关帕金森病患者吞咽障碍评估及管理的最佳证据。方法  遵循“6S”证据金字塔模型，系统检索 UpToDate，BMJ Best Practice，澳大利亚 Joanna Briggs Institute（JBI）循证卫生保健中心数据库、国际指南协作网（Guidelines International Network，GIN）、英国国家卫生与临床优化研究所（National Institute for Health and Care Excellence，NICE）、苏格兰院际指南网（Scottish Intercollegiate Guidelines Network，SIGN）、国际帕金森和运动障碍协会网站（InternationalParkinson and Movement Disorder Society，MDS）、欧洲神经病学学会网站（European Academy of Neurology，EAN）、加拿大帕金森学会网站（Parkinson Society Canada，PSC）、Cochrane Library，PubMed，EMbase，CINAHL，中国知网、万方、SinoMed 以及中国医脉通临床指南网，收集关于帕金森病患者吞咽障碍评估及管理的临床决策、指南、专家共识、系统评价、证据总结和随机对照试验。检索时限为建库至 2025 年 2 月 28 日。对相关文献进行质量评价和证据汇总，并采用 JBI 证据预分级系统（2014 版）对纳入证据进行分级。结果  共纳入文献 18 篇，其中指南 5 篇、专家共识 4 篇、临床决策 2 篇、系统评价 2 篇、证据总结 4 篇、随机对照试验 1 篇，从多学科管理、筛查与评估、营养管理、康复管理、流涎管理、并发症预防 6 个方面整合了 39 条最佳证据。结论  本研究对帕金森病患者吞咽障碍评估及管理的最佳证据进行系统总结，为医护人员提供循证依据，临床应用时可依据具体临床情境、专业意见及患者个人状况，挑选最适宜的证据，制定个性化管理方案。

Objective To select，evaluate and summarise the best evidence for assessment and management of dysphagia in patients with Parkinson’s disease. Methods Following the Pyramid Model，systematic searches were conducted on following databases from the inception to 28th February，2025：Up To Date，BMJ Best Practice，Joanna Briggs Institute（JBI）EBP Database，Guidelines International Network（GIN），National Institute for Health and Care Excellence（NICE），Scottish Intercollegiate Guidelines Network （SIGN），International Parkinson and Movement Disorder Society（MDS），European Academy of Neurology（EAN），Parkinson Society Canada（PSC），Cochrane Library，PubMed，Embase，CINAHL，China National Knowledge Infrastructure（CNKI），Wanfang Data， SinoMed and Medlive. Searches targeted clinical decisions，guidelines，expert consensus，systematic reviews，evidence summaries，and randomised controlled trials related to assessment and management of dysphagia in patients with Parkinson’s disease. After quality evaluation of the searched literature，evidence for dysphagia in patients with Parkinson’s disease was summarised and categorised using the JBI Evidence Pre-Classification System（2014 edition）. Results A total of 18 articles were included，they were 5 guidelines，4 expert consensus，2 clinical decisions，2 systematic reviews，4 evidence summaries and 1 randomised controlled trial. Thirty-nine items of best evidence were extracted，covering 6 categories：multidisciplinary management，screening and evaluation，nutrition management， rehabilitation management，drooling management and complication prevention. Conclusion This study systematically summarises the best evidence for assessment and management of dysphagia in patients with Parkinson’s disease，providing an evidence-based guidance for healthcare professionals to develop individualised management plans based on specific clinical contexts，professional opinions and the conditions of the patients.