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观点:使用支气管扩张症行动管理计划治疗支气管扩张症患儿——能否改善临床护理?

Perspective: Using Bronchiectasis Action Management Plans for Children With Bronchiectasis-Can It Improve Clinical Care?

作者信息

Schutz Kobi L, Marchant Julie M, Chang Anne B, Turner Catherine, Chatfield Mark D, McCallum Gabrielle B

机构信息

Child Health Division, Menzies School of Health Research, Darwin, NT, Australia.

College of Nursing and Midwifery, Charles Darwin University, Darwin, NT, Australia.

出版信息

Front Pediatr. 2019 Oct 30;7:428. doi: 10.3389/fped.2019.00428. eCollection 2019.

Abstract

While once thought to be rare, bronchiectasis has been increasing globally over the last 15 years. Bronchiectasis is a major contributor to chronic lung morbidity and mortality but remains a neglected disease in respiratory health globally. Currently, few high-level evidence-based management strategies are available for children with bronchiectasis. Strategies to improve clinical outcomes associated with exacerbations are important. In other respiratory conditions such as asthma and chronic obstructive pulmonary disease, use of personalized written management plans have been shown to improve clinical outcomes. Personalized management plans have also been recommended as part of treatment plans in adults with bronchiectasis. We thus undertook a review of the current literature to determine available evidence, and to establish whether a personalized written bronchiectasis action management plan (BAMP) improves clinical outcomes in children with bronchiectasis. Our search identified 43 articles; 16 duplicates were removed and a further 23 were excluded on titles and abstracts alone. Four full-text articles were reviewed but excluded. In the absence of any published studies, it remains unknown whether the use of BAMP is beneficial for improving clinical outcomes for children with bronchiectasis. These results have highlighted this clinical gap and identified the need for high-quality research to inform practice. Until high-quality evidence is available, clinicians are advised to adhere to current national and/or international guidelines.

摘要

支气管扩张症曾被认为较为罕见,但在过去15年里全球发病率一直在上升。支气管扩张症是慢性肺部发病和死亡的主要原因,但在全球呼吸健康领域仍是一种被忽视的疾病。目前,针对患有支气管扩张症的儿童,几乎没有基于高级别证据的管理策略。改善与病情加重相关的临床结局的策略很重要。在哮喘和慢性阻塞性肺疾病等其他呼吸道疾病中,使用个性化书面管理计划已被证明可改善临床结局。个性化管理计划也被推荐作为成人支气管扩张症治疗计划的一部分。因此,我们对当前文献进行了综述,以确定现有证据,并确定个性化书面支气管扩张症行动管理计划(BAMP)是否能改善支气管扩张症患儿的临床结局。我们的检索共找到43篇文章;去除16篇重复文章,仅根据标题和摘要又排除了23篇。对4篇全文文章进行了审阅但予以排除。由于没有已发表的研究,使用BAMP是否有利于改善支气管扩张症患儿的临床结局仍不清楚。这些结果凸显了这一临床差距,并确定了开展高质量研究以指导实践的必要性。在获得高质量证据之前,建议临床医生遵循现行的国家和/或国际指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7df6/6831557/82328a4e7b32/fped-07-00428-g0001.jpg

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