ISSN 2096-7446　CN 10-1655/R
主管：中国科协技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (8): 704-710.doi: 10.3761/j.issn.2096-7446.2023.08.006

• 早期康复护理专题 • 上一篇    下一篇

心脏瓣膜置换术后患者ICU卧床期间早期康复的最佳证据总结

王丹华 陈金 刘海迎 黄冬雪 李旭光 高燕 原志芳 林梅 沈悦好   

  • 出版日期:2023-08-10 发布日期:2023-08-17

Evidence summary of ICU early rehabilitation in bed for patients after cardiac valve replacement

WANG Danhua，CHEN Jin，LIU Haiying，HUANG Dongxue，LI Xuguang，GAO Yan，YUAN Zhifang，LIN Mei，SHEN Yuehao   

  • Online:2023-08-10 Published:2023-08-17

摘要： 目的 系统检索心脏瓣膜置换术后患者ICU卧床期间早期康复的最佳证据，为患者 卧床期间的早期康复提供指导。方法 计算机检索BMJ Best Practice、UpToDate、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library、加拿大安大略省注册护士协会、苏格兰校际指南网、英国国家卫生与临床优化研究所、WHO官方网站、医脉通、美国心脏病学会、欧洲心胸外科协会等专业相关网站、Web of Science、PubMed、中国生物医学文献数据库、中国知网、万方数据库、维普数据库中与心脏瓣膜置换术后患者ICU卧床期间早期康复有关的临床决策、最佳实践、指南、专家共识、系统评价、证据总结、原始研究。检索时限为建库至2023年3月。 由2名研究者进行文献质量评价，并对证据进行提取与汇总。 结果 纳入9篇文献，分别为1篇临床决策、3篇指南、1篇专家共识、1篇系统评价、1篇证据总结、2篇随机对照试验，共提取证据18条，分为多学科参与、康复前评估、运动训练、个体化按摩、呼吸训练、动态评估、健康教育7个方面。 结论 该研究总结了心脏瓣膜置换术后患者ICU卧床期间早期康复的最佳证据， 医护人员需结合本科室现状及患者情况，构建患者卧床期间早期康复方案，促进患者术后早期康复的实施。

关键词: 心脏瓣膜成形术, 重症监护病房, 康复护理, 循证护理学

Abstract: Objective To retrieve the relevant evidence for ICU early rehabilitation in bed for patients after cardiac valve replacement，and to provide a guidance for ICU early rehabilitation for patients in bed. Methods A computer search was performed on BMJ Best Practice，UpToDate，Joanna Briggs Institute library，Cochrane Library， Registered Nurses’ Association of Ontario（RNAO），Scottish Intercollegiate Guidelines Network （SIGN），National Insti- tute for Health and Care Excellence （NICE），WHO，Clinical guideline，American College of Cardiology，European As- sociation for Cardiothoracic Surgery，Web of Science，PubMed，Chinese Biomedical Literature Database，China Knowl- edge Infrastructure，Wanfang Database，and VIP Database on early rehabilitation in patients after cardiac valve re- placement，including clinical decision-making，guidelines，expert consensus，systematic review，evidence summary，primary research. The retrial period was from database establishment to March，2023. Two researchers with master’s degree and evidence-based knowledge evaluated the quality of the literatures，and then extracted and summarized the evidence. Results A total of 9 articles were included，including one clinical decision-making，three guidelines， one expert consensuses，one systematic review，two randomized control trials and one evidence summary. The best evidence included 18 recommendations in 7 aspects，multidisciplinary participation，pre-rehabilitation assessment，exercise training，individual massage，respiratory training，dynamic assessment and health education. Conclusion Our re- search summarized the best evidence of ICU early rehabilitation in bed for patients after cardiac valve replacement. The medical staff should apply evidence selectively according to the current situation of the department and the patients to construct the early rehabilitation program for the patients in bed，so as to promote postoperative early rehabilitation.

Key words: Cardiac Valve Annuloplasty, Critical Care Units, Rehabilitation Nursing, Evidence-Based Nursing