心脏瓣膜置换术后患者Ⅰ期心脏康复的最佳证据总结

doi:10.16460/j.issn1008-9969.2019.18.032

摘要/Abstract

摘要： 目的检索和获取国内外心脏瓣膜置换术后患者Ⅰ期心脏康复的最佳证据,为医护人员、管理者、患者进行Ⅰ期心脏康复临床实践提供参考。方法用PIPOST模式构建循证问题,制定严密的检索策略和纳入排除标准,系统检索心脏瓣膜置换术后患者Ⅰ期心脏康复的相关证据,从中筛选出符合纳入标准的文献。由2名有资质的研究者对纳入的文献采用对应的评价工具独立进行质量评价、证据提取和综合。结果共纳入9篇文献,其中3篇指南、1篇系统评价、3篇随机对照试验研究、1篇类实验研究和1篇专家共识。从9篇文献中共提取20条证据,综合成5个维度,17条最佳证据,分别为评估、综合呼吸功能训练、阶段性运动训练、运动观察和健康教育。结论护理管理者需加强护理人员心脏康复知识的培训,并结合医疗机构的临床环境、护理人员的专业判断、患者意愿等有针对性的选择证据。

关键词: 心脏瓣膜病, 心脏康复, 院内康复, 最佳证据, 循证护理

Abstract: Objective To summarize the best evidence of cardiac rehabilitation of patients after heart valve replacement and to provide reference for domestic cardiac rehabilitation. Methods With questions developed by PIPOST, a rigorous search strategy, inclusion criteria and exclusion criteria were developed, we searched original research for evidence of cardiac rehabilitation in adult patients after heart valve replacement, and extracted the evidence of the literatures meeting the quality standards. Two researchers used the corresponding evaluation tools to conduct quality evaluation, evidence extraction and synthesis independently. Results Nine studies were found, including three clinical practice guidelines, one systematic review, three RCTs, one CCT and one consensus. Totally 20 items of evidence were summarized and five dimensions including assessment, comprehensive respiratory function training, periodic sport training, sport observation and health education and 17 items of best evidence were extracted. Conclusion Nursing administrators should strengthen education on cardiac rehabilitation among nurses,when choosing the best evidence, clinical environment, professional judgment of nurses and patients' willingness should be taken into consideration.

Key words: heart valve disease, cardiac rehabilitation, hospital rehabilitation, best evidence, evidence-based nursing

中图分类号:

R473.54

何文斌, 廖尧, 尹熙, 杨茜, 胡君娥, 严妍, 周雪果, 姚小云, 陈红宇. 心脏瓣膜置换术后患者Ⅰ期心脏康复的最佳证据总结[J]. 护理学报, 2019, 26(18): 32-36.

HE Wen-bin, LIAO Raon, YIN Xi, YANG Qian, HU Jun'e, YAN Yan, ZHOU Xue-guo, YAO Xiao-yun, CHEN Hong-yu. Evidence Summary for Cardiac Rehabilitation in Patients after Cardiac Valve Replacement[J]. Journal of Nursing, 2019, 26(18): 32-36.

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