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 ›› 2024, Vol. 5 ›› Issue (3): 214-221.doi: 10.3761/j.issn.2096-7446.2024.03.004

• 心脏康复护理专题 • 上一篇    下一篇

经导管主动脉瓣置换术患者居家心脏康复的最佳证据总结

贾盈盈 宋剑平 张倩 庞琳雁 牛姗   

  • 出版日期:2024-03-10 发布日期:2024-03-25

Summary of the best evidence for home cardiac rehabilitation in patients undergoing transcatheter aortic valve replacement

JIA Yingying，SONG Jianping，ZHANG Qian，PANG Linyan，NIU Shan   

  • Online:2024-03-10 Published:2024-03-25

摘要： 目的 提取、评价和整合经导管主动脉瓣置换术（transcatheter aortic valve replacement， TAVR）患者居家心脏康复管理相关证据，以期为TAVR患者居家心脏康复提供依据。 方法 全面检索国内外数据库、指南网站、心血管相关协会网站中与TAVR患者居家心脏康复相关的指南、专家共识、证据总结、临床决策、推荐实践、系统评价，检索时限均为建库至2023年11月 1日。 2名研究员独立评价文献质量，并提取证据、总结主题。 结果 共纳入16篇文献，其中 专家共识5篇、指南7篇、临床决策4篇，从康复风险评估、居家健康教育、居家运动康复、风险因素管理、居家抗凝管理、居家并发症管理、居家随访管理7个方面汇总了26条最佳证据。 结论 康复团队可根据患者的病情和意愿，结合最佳证据，严格筛选参与居家康复的患者。 重点开展抗凝管理、并发症管理及随访管理，以实现对瓣膜功能的动态监测，降低术后并发症的发生率，同时提高患者的康复依从性。

关键词: 经导管主动脉瓣置换术, 心脏康复, 延续性护理, 证据总结, 循证护理学

Abstract: Objective To extract，evaluate，and integrate evidence related to the management of home cardiac rehabilitation for patients undergoing transcatheter aortic valve replacement （TAVR），with the aim of providing a basis for home cardiac rehabilitation for TAVR patients. Methods We comprehensively searched domestic and international databases，guideline websites，and websites of cardiovascular-related associations for clinical guidelines， expert consensuses，evidence summaries，clinical decision-making，recommended practices，and systematic reviews related to home cardiac rehabilitation for patients with TAVR，with a timeframe from the establishment of the databases to November 1，2023. Two researchers independently evaluated the quality of the literature and extracted relevant topics and evidence. Results A total of 16 papers were included，including 5 expert consensus papers，7 guidelines，and 4 clinical decisions，and 26 pieces of best evidence were summarized in 7 aspects：rehabilitation risk assessment，home health education，home exercise rehabilitation，risk factor management，home anticoagulation management，home complication management，and home follow-up management. Conclusion The rehabilitation team can rigorously screen patients for participation in rehabilitation based on their condition and preference， incorporating the best evidence. The focus is on anticoagulation management，complication management，and follow- up management to enable dynamic monitoring of valve function，reduce the incidence of postoperative complications， and improve patient compliance with rehabilitation.

Key words: Transcatheter Aortic Valve Replacement, Cardiac Rehabilitation, Extended Care, Summary of Evidence, Evidence-Based Nursing