心脏起搏器术后患者早期运动康复的最佳证据总结

Best Evidence Summary of Early Exercise Rehabilitation after Pacemaker Implantation

目的检索并评价心脏起搏器术后患者早期运动康复的相关证据,对其所获取证据进行总结,为临床实践提供参考。方法通过护理循证方法确立问题,按照循证检索数据库的“6 S”分类模型,检索与“心脏起搏器术后早期运动康复”相关证据,证据包括临床指南、系统评价、专家共识和证据总结,并由2名完成循证护理培训的研究员对纳入文献独立评价,同时对遴选出符合质量标准的文献进行证据提取。结果共纳入证据文献6篇,包括临床指南1篇,专家共识4篇、系统评价1篇,并对证据进行汇总,最终总结了16条最佳证据。证据内容包括运动前评估、运动计划、运动开始指征、运动监督、运动方式及强度、出院指导6个主题。结论心脏起搏器术后患者开展早期运动康复,需要专业康复团队进行全面的综合评估:包括临床综合症状的评估和起搏器功能的评估,同时借助专业的辅助工具,对康复过程进行安全监测,采用渐进方式逐步增加锻炼强度以期降低术后并发症,确保早期运动康复的安全性,从而提升患者舒适度。

Objective To retrieve and summarize the relevant evidence of early exercise rehabilitation in patients after pacemaker implantation,and to provide reference for clinical practice.Methods The problem was identified through the nursing evidence-based method.According to the“6S”classification model of the evidence-based retrieval,the evidence related to“early exercise rehabilitation after pacemaker implantation”was retrieved including clinical guidelines,systematic review,expert consensus and evidence summary.Two researchers who completed evidence-based nursing training independently evaluated the included literature and extracted evidence from eligible literature.Results Six pieces of literature were attained,including 1 clinical guideline,4 expert consensuses,and 1 systematic review.Sixteen pieces of best evidence were summarized into 6 themes:pre-exercise assessment,exercise plan,indications for exercise initiation,exercise supervision,exercise mode and intensity,and discharge guidance.Conclusion Early exercise rehabilitation of patients after pacemaker transplantation requires a comprehensive evaluation by a professional rehabilitation team,including the evaluation of clinical syndromes and pacemaker function,and at the same time,with the help of professional auxiliary tools,the rehabilitation process should be safely monitored.Gradually increased exercise intensity may help to reduce postoperative complications,ensure the safety of early exercise rehabilitation,and improve patient comfort.