糖尿病足患者运动管理的最佳证据总结

Best evidence summary on exercise management in patients with diabetic foot

目的检索、评价、总结糖尿病足患者运动管理的最佳证据,为临床制订糖尿病足患者运动方案提供循证依据。方法计算机检索BMJ Best Practice、UpToDate、英国国家卫生与临床优化研究所、加拿大安大略注册护士协会、苏格兰院际指南网、医脉通、国际糖尿病足工作组、国际糖尿病联盟、美国糖尿病协会、中华医学会糖尿病学分会、中华医学会内分泌学分会、Joanna Briggs Institute循证卫生保健中心数据库、Cochrane Library等国内外数据库和专业协会网站中有关糖尿病足患者运动管理的证据,包括最佳实践信息册、推荐实践、指南、证据总结、系统评价、专家共识。检索时限为建库至2021年4月30日。由2~4名研究者对纳入的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13篇文献,包括4篇指南、6篇证据总结、3篇系统评价,围绕糖尿病足患者运动评估、运动方式、运动强度、运动时间及频率、运动安全5个方面共总结出17条最佳证据。结论本研究总结了糖尿病足患者运动管理的最佳证据,临床医护人员应根据糖尿病足患者全身及局部血管、神经病变,足溃疡等的严重程度制订个体化的运动方案,以保证患者运动的有效性与安全性。

Objective To retrieve,evaluate and summarize the best evidence of exercise management for diabetic foot patients,so as to provide an evidence-based evidence for clinical formulation of exercise programs for diabetic foot patients.Methods Evidence on exercise management for patients with diabetic feet was retrieved by computer in the British Medical Journal(BMJ)Best Practice,UpToDate,National Institute for Health and Clinical Excellence,Registered Nurses'Association of Ontario,Scottish Intercollegiate Guidelines Network,Medlive,International Working Group on Diabetic Foot,International Diabetes Federation,American Diabetes Association,Chinese Diabetes Society,Chinese Society of Endocrinology,Joanna Briggs Institute Evidence-based Health Care Center,Cochrane Library and other domestic and foreign databases and professional association websites.Evidence included best practice information books,recommended practices,guidelines,evidence summaries,systematic reviews,and expert consensus.The retrieval time limit was from the establishment of the database to April 30,2021.Two to four investigators independently assessed the quality of the included article,and extracted and summarized the evidence that met the quality standards.Results A total of 13 articles were included,involving 4 guidelines,6 evidence summaries,and 3 systematic reviews.A total of 17 best evidences were summed up in five aspects,namely exercise assessment,exercise mode,exercise intensity,exercise time and frequency,and exercise safety in diabetic foot patients.Conclusions This article summarizes the best evidence for exercise management in patients with diabetic foot.Clinical medical and nursing staff should formulate individualized exercise programs according to the severity of systemic and local blood vessels,neuropathy and foot ulcers in patients with diabetic foot to ensure the effectiveness and safety of patients'exercise.