肾移植患者围术期运动锻炼的最佳证据总结

Best evidence for perioperative exercise in kidney transplant patients

目的 总结肾移植患者围术期运动锻炼的最佳证据,为临床医护人员对肾移植患者进行运动锻炼提供证据。方法 按照PIPOST模式确定循证问题,根据“6S”证据模型,计算机检索BMJ Best Practice,UpToDate,世界卫生组织,美国国立指南网,中华医学会肾脏病学分会网站,英国肾脏病协会网站,美国肾脏病协会网站,中国知网,万方数据知识服务平台,维普等数据库中有关肾移植受者围手术期运动锻炼的所有证据,包括临床指南、临床决策、系统评价、证据总结及专家共识等,检索时限为建库至2023年8月。由2名护理研究生独立对文献进行质量评价及证据提取。结果 共纳入13篇文献,其中临床决策1篇、指南1篇、专家共识3篇、系统评价8篇。从运动益处、运动评估、术前运动策略、术后运动策略、注意事项、运动指导监控、运动支持7个方面共总结了24条最佳证据。结论 本研究总结有关肾移植围术期运动锻炼的最佳证据,为规范化肾移植围术期运动锻炼提供参考。临床医护人员应充分识别肾移植患者运动锻炼的阻碍与促进因素,基于医疗情景、患者病情、结合患者运动意愿制订个性化的运动锻炼方案。

Objective To summarize the best evidence for perioperative exercise in renal transplant patients and provide evidence-based evidence for clinical staff to perform exercise in renal transplant patients.Methods Evidence-based questions were identified according to the PIPOST model,and computerized searches were conducted on BMJ Best Practice,UpToDate,the World Health Organization,the US National Guidelines,the website of the Chinese Society of Nephrology,the website of the British Renal Association,the website of the American Society of Nephrology,CNKI,the knowledge service platform of Wanfang Data,the Wipo database and other databases for all evidence on perioperative exercise in renal transplant recipients,including clinical guidelines,clinical decisionmaking,systematic evaluations,evidence summaries,and expert consensus,with a timeframe for searching from the establishment of the database to August 2023.Quality assessment and evidence extraction of the literature were performed independently by 2 nursing graduate students.Results A total of 13 publications were included,including 1 clinical decision,1 guideline,3 expert consensus,and 8 systematic evaluations.A total of 24 pieces of best evidence were summarized in 7 areas:exercise benefits,exercise assessment,preoperative exercise strategies,postoperative exercise strategies,precautions,exercise instruction monitoring,and exercise support.Conclusions This study summarizes the best evidence about perioperative exercise exercise in renal transplantation and provides a reference for standardizing perioperative exercise exercise in renal transplantation.Clinical staff should fully identify the impediments and facilitators of exercise exercise in renal transplant patients,and develop personalized exercise exercise programs based on medical scenarios,patient conditions,and combined with patients’exercise wishes.