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

doi:10.3761/j.issn.2096-7446.2024.03.004

摘要/Abstract

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

贾盈盈, 宋剑平, 张倩, 庞琳雁, 牛姗. 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[J]. 中华急危重症护理杂志, 2024, 5(3): 214-221.

JIA Yingying, SONG Jianping, ZHANG Qian, PANG Linyan, NIU Shan. Summary of the best evidence for home cardiac rehabilitation in patients undergoing transcatheter aortic valve replacement[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(3): 214-221.

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