食管癌病人术前预康复策略的最佳证据总结

Summary of the best evidence on preoperative prehabilitation strategies for patients with esophageal cancer

目的:系统评价食管癌病人术前预康复策略的最佳证据,为医护人员指导食管癌病人进行术前预康复提供循证依据。方法:计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、中华医学期刊全文数据库及医脉通、中华护理学会、中国加速康复外科等网站中关于食管癌病人术前预康复的文献,检索时限从建库至2023年9月30日;由2名研究人员对文献进行筛选和质量评价,并进行证据的提取和汇总。结果:共纳入13篇文献,包括1篇指南、1篇临床决策、6篇专家共识、3篇系统评价和2篇随机对照试验,形成了包括预康复的目的、时机、术前宣教、多学科团队建设以及营养、运动、心理的评估和干预7个方面共22条最佳证据。结论:本研究总结的食管癌病人术前预康复策略的最佳证据,临床医护人员在进行证据转化时应充分考虑临床实际,个性化地将其应用于临床,促进食管癌手术病人快速康复。

Objective:To systematically evaluate the best evidence of preoperative prehabilitation strategies for esophageal cancer patients,and to provide an evidence-based basis for healthcare professionals to guide preoperative prehabilitation for esophageal cancer patients.Methods:A computerized search was conducted on CNKI,WanFang Database,VIP,CBM,Chinese Medical Journal Full Text Database,Medical Pulse,Chinese Nursing Association,and China Accelerated Rehabilitation Surgery on preoperative prehabilitation of patients with esophageal cancer,with a time frame from the establishment of the database to September 30,2023;two researchers screened and evaluated the literature for quality,and the evidence was extracted and summarized.Results:A total of 13 articles were included in the literature,including 1 guideline,1 clinical decision,6 expert consensus,3 systematic evaluations,and 2 randomized controlled trials,resulting in a total of 22 pieces of best evidence in 7 areas,including the purpose and timing of prehabilitation,preoperative education,multidisciplinary team building,and nutritional,exercise,and psychological assessments and interventions.Conclusion:The best evidence of preoperative prehabilitation strategies for patients with esophageal cancer summarized in this study should be personalized and applied to the clinic by clinical healthcare professionals with full consideration of clinical reality when translating the evidence to promote rapid recovery of patients undergoing esophageal cancer surgery.