心脏术后患者ICU早期康复锻炼的最佳证据总结

Summary of best evidence on early rehabilitation exercise for patients after cardiac surgery

目的提取并总结心脏术后患者ICU早期康复锻炼的最佳证据,为临床早期康复的开展提供参考。方法计算机检索Medline、Up To Date、PubMed、Cochrane Library、CINAHL、JBI循证卫生保健数据库及万方、知网、医脉通数据库,根据纳排标准选取临床指南、专家共识、最佳证据总结、系统评价等,由2名研究人员进行文献质量评价后提取证据。结果共纳入12篇文献,从组建多学科团队、康复前评估、制订康复计划、心脏早期康复方案、康复过程动态评估、康复后评估、心理干预、健康教育8个方面对心脏术后患者早期康复进行总结,共34条证据。结论本证据可为临床医护人员制订ICU心脏术后患者早期康复方案提供参考,建议证据转化时,应结合我国的医疗文化背景和证据应用场所,以及患者的需求和意愿。

Objective To extract and summarize the best evidence on early rehabilitation exercise for patients with cardiac surgery in ICU,and to provide evidence for implement of early rehabilitation in such patients.Methods Computer-aided search was conducted in such databases as Medline,Up To Date,PubMed,Cochrane Library,CINAHL,JBI Evidence-Based Practice database,Wanfang,CNKI and Medlive,to retrieve clinical guidelines,expert consensus reports,best evidence summary reports,and systematic reviews,etc.Two researchers evaluated the quality of the included literature and extracted the evidence.Results A total of 12 publications were included.A tally of 34 pieces of evidence,which were categorized into such 8 aspects,as establishing a multidisciplinary team,pre-rehabilitation assessment,formulating rehabilitation plans,setting early cardiac rehabilitation plans,dynamic eva-luation of rehabilitation process,post-rehabilitation assessment,psychological intervention and health education,were summarized.Conclusion The summarized evidence could serve as references for clinical staff to formulate early rehabilitation plans for ICU patients after cardiac surgery.It is suggested that the transformation of evidence should be based on China′s medical service culture and the sites for evidence application,as well as the needs and preferences of patients.