心脏移植术后患者出院随访的最佳证据总结

Summary of the best evidence for follow-up of patients after heart transplantation

目的总结心脏移植术后患者出院随访的最佳证据,为临床实践提供参考。方法按照"6S"证据模型,系统检索美国指南网、英国卫生与临床优化研究所、苏格兰校际指南网、加拿大医学会临床实践指南文库、澳大利亚国家卫生和医学研究委员会网站、国际指南网、医脉通等指南网及PubMed、CINAHL、Embase、UpToDate、BMJ best practice、Joanna Briggs Institute(JBI)循证卫生保健中心数据库、Cochrane Library、CNKI、万方、中国生物医学文献和维普等数据库中关于心脏移植术后患者出院随访的证据,包括系统评价、指南和专家共识等。检索时限为建库至2020年10月。由2名研究人员对文献质量进行独立评价,并对符合质量标准的文献进行证据提取和汇总。结果共纳入文献10篇,包括指南2篇、系统评价7篇、专家共识1篇。从随访团队构成及要求、随访频率、随访内容、病情监测、评估和提高治疗依从性、评估和改善心理状况、运动与康复、并发症的预防和管理8个主题汇总了26条证据。结论本研究总结了心脏移植术后患者出院随访的最佳证据,医务人员可根据患者意愿和临床具体情况,结合专业判断,形成有效、可行的护理策略,从而对患者实施科学随访管理。

Objective To summarize the best evidence for follow-up patients after heart transplantation so as to provide a reference for clinical practice.Methods According to the"6S"evidence model,we systematically searched the National Guideline Clearinghouse,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,Clinical Practice Guideline of Canadian Medical Association,Australian Government National Health and Medical Research Council,Guidelines International Network and Medlive and other guide networks,and PubMed,CINAHL,Embase,UpToDate,British Medical Journal(BMJ)best practice,Joanna Briggs Institute(JBI)Evidence-based Practice Database,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Database,Chinese Biology Medicine Literature,VIP and other databases for the evidence on the follow-up of patients after heart transplantation.The evidence included systematic reviews,guidelines,and expert consensus.The search time limit was from the establishment of the database to October 2020.Two researchers independently evaluated the quality of literature,and extracted and summarized the evidence that met the quality standards.Results A total of 10 articles were included,including 2 guidelines,7 systematic reviews,and 1 expert consensus.A total of 26 pieces of evidence were collected from 8 topics including follow-up team composition and requirements,follow-up frequency,follow-up content,condition monitoring,evaluation and improvement of treatment compliance,evaluation and improvement of psychological conditions,exercise and rehabilitation,and prevention and management of complications.Conclusions This study summarizes the best evidence for follow-up patients after heart transplantation.Medical and nursing staff can form effective and feasible nursing strategies according to the patient's wishes and specific clinical conditions,combined with professional judgment,so as to implement scientific follow-up management of patients.