1例成骨不全患儿外固定架固定术后护理的循证康复实践

Evidence-based Nursing Practice for Postoperative Rehabilitation of a Patient with Osteogenes Isimperfecta after External Fixation

目的为1例成骨不全患儿外固定架固定术后制定安全有效的康复方案。方法在全面评估患儿病情的基础上,提出临床问题,全面检索美国国立指南库(NGC)、Cochrane Library、Pub Med、CBM、CNKI、万方数据库,并追溯参考文献,将获得的高质量临床证据结合患儿情况及家属意愿,制定康复方案。结果共检出随机对照试验1篇,病例报告4篇。制定渐进性康复训练计划并实施,康复期间患儿无新发骨折,肌力、步态、日常生活活动能力等有较大改善。20周时Berg评分43分,Barthel指数80分。结论采用循证的方法,为该成骨不全患儿外固定架固定术后制定的渐进性康复训练方案,安全性、有效性、可行性均较好,有利于患儿回归家庭,回归社会。

Objective To make an evidence-based rehabilitation plan for a patient with osteogenesis imperfecta after external fixation.Methods Based on a comprehensive assessment for the patient＇s condition, the clinical problems were listed. Related articles were searched from National Guideline Clearinghouse（NGC）, The Cochrane Library, Pub Med, CBM, CNKI and Wanfang databases. And the reference list of each eligible article was also included. Finally the optimum rehabilitation program was designed with optimal clinical evidence, patient＇s conditions and relatives＇ willingness. Results 1 randomized controlled trial and 4 case reports were included. A progressive exercise program was developed and implemented. No new fractures occurred during the intervention. Muscle strength, gait, activities of daily living had been greatly improved. 20 weeks later, the Berg score was 43 and the Barthel index was 80. Conclusion The progressive rehabilitation exercise program developed from evidence-based practice is safe, effective and feasible.