Department of Nursing and Health Care, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland.
School of Humanities, Waterford Institute of Technology, Waterford, Ireland.
J Clin Nurs. 2019 Dec;28(23-24):4190-4206. doi: 10.1111/jocn.15009. Epub 2019 Aug 8.
To review published literature pertaining to the management of sialorrhoea while also highlighting the significance of the multidisciplinary approach.
Sialorrhoea is a common and troublesome problem among certain neurological patients. It is distressing for patients and caregivers, and can be challenging for healthcare professionals. Various sialorrhoea management approaches have been documented. However, there is no clear consensus on best management practices. Therefore, it is necessary to systematically review and synthesise various approaches so as to provide an understanding of the efficacy of management approaches.
Systematic literature review using PRISMA checklist (see Appendix S1).
Five databases (ScienceDirect, Wiley Online Library, CINAHL, Cochrane Library and PubMed) were searched (years 2001-2018) following inclusion criteria. Out of 1,294 identified records, 29 studies met the inclusion criteria.
Various management approaches identified, ranging from noninvasive, such as speech therapy aiming to enhance swallowing behaviour, to invasive treatment including anticholinergic medication, botulinum toxin injection and surgical techniques. However, in the majority of cases, there is no scientific evidence-based management protocol leading to favourable results, and the evidence base for intervention effectiveness remains weak.
The multifactor nature of sialorrhoea and its associated complications presents challenges for the medical care team. None of the management strategies stand alone as the best modality; therefore, it is proposed that management strategies follow a multidisciplinary approach to meet the diverse needs of patients.
A comprehensive understanding of different sialorrhoea management approaches will enable healthcare professionals to identify the signs and symptoms regarding sialorrhoea, and to assist in effective management implementation. This will help to improve the management of sialorrhoea, hence, to improve quality of life of patients and provide formative scope to the development of an integrated care pathway.
回顾已发表的与流涎症管理相关的文献，并强调多学科方法的重要性。
流涎症是某些神经科患者常见且令人困扰的问题。它给患者和护理人员带来困扰，也给医疗保健专业人员带来挑战。已经记录了各种流涎症管理方法。然而，对于最佳管理实践并没有明确的共识。因此，有必要系统地回顾和综合各种方法，以了解管理方法的疗效。
使用 PRISMA 检查表进行系统文献回顾（见附录 S1）。
根据纳入标准，在五个数据库（ScienceDirect、Wiley Online Library、CINAHL、Cochrane Library 和 PubMed）中进行了搜索（2001 年至 2018 年）。在 1294 条已识别记录中，有 29 项研究符合纳入标准。
确定了各种管理方法，从非侵入性的方法，如旨在增强吞咽行为的言语治疗，到侵入性治疗，包括抗胆碱能药物、肉毒杆菌毒素注射和手术技术。然而，在大多数情况下，没有基于科学证据的管理方案能带来有利的结果，干预效果的证据基础仍然薄弱。
流涎症的多因素性质及其相关并发症给医疗保健团队带来了挑战。没有一种管理策略可以单独作为最佳模式；因此，建议管理策略遵循多学科方法，以满足患者的多样化需求。
全面了解不同的流涎症管理方法将使医疗保健专业人员能够识别与流涎症相关的体征和症状，并协助实施有效的管理。这将有助于改善流涎症的管理，从而提高患者的生活质量，并为制定综合护理途径提供形成性的范围。
