乳腺癌相关淋巴水肿患者运动管理的最佳证据总结

Best evidence of exercise management of patients with breast cancer-associated lymphedema

目的检索与总结乳腺癌相关淋巴水肿(breast cancer-related lymphedema,BCRL)患者运动的最佳证据,旨在为临床实践提供科学、可操作的实践指导。方法计算机检索BMJ Best practice、Up To Date、乔安娜布里格斯研究所、世界卫生组织、加拿大安大略护理学会网站、Cochrane Library、PubMed、Web of Science、中国知网、万方数据库等BCRL患者运动管理的相关证据,检索时限为建库至2019年12月22日。由2名研究者采用澳大利亚JBI循证卫生保健中心的文献评价标准和证据分级系统,对所纳入的文献进行质量评价及证据级别评定。结果共纳入15篇文献,包括推荐实践1篇,临床决策1篇,证据总结3篇,临床实践指南3篇,系统评价4篇,专家共识3篇;包括评估、运动方式、运动强度以及安全运动4个方面,共20条证据。结论本研究总结了BCRL患者运动管理的证据,可为患者运动管理提供循证依据,以便降低BCRL的发生率和缓减BCRL的疾病进展。

Objective To summarize the best evidence of exercise of patients with breast cancer-related lymphedema(BCRL)in order to provide scientific and practical guidance for clinical practice.Methods A systematic review was done to search the evidence of exercise management of BCRL patients all through such websites or databases of BMJ Best practice,Up To Date,Joanna Briggs Institute,World Health Organization,Registered Nurses'Association of Ontario,Cochrane Library,PubMed,Web of Science,CNKI,Wanfang Database,from the inception to December 22th,2019.The included literature was evaluated and categorized by two researchers,using the literature evaluation standards of the Australian JBI Evidence-based Health Care Center.Results A total of 15 articles were included,including 1 recommended practice,1 clinical decision,3 evidence summaries,3 clinical practice guidelines,4 systematic reviews,and 3 expert consensus;involving assessment,exercise style,exercise intensity and safe exercise with 20 pieces of evidence in them.Conclusion This study summarizes the evidence of exercise management in patients with BCRL,which can provide evidence-based basis for patient exercise management in order to reduce the incidence of BCRL and slow down its progression.