肺癌术前预康复管理的最佳证据总结

Summary of the best evidence for preoperative prehabilitation management of lung cancer

目的:系统性总结肺癌术前预康复管理的最佳证据,为医护人员开展术前预康复临床实践提供参考依据,以期提高肺癌术前预康复管理质量。方法:系统检索英国医学杂志(British Medical Journal,BMJ)Best Practice、UpToDate、澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、美国国立临床诊疗指南数据库、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、国际指南协作网、新西兰指南协作组、医脉通、Cochrane Library、PubMed、Embase、中国知网、万方数据库关于肺癌术前预康复的相关证据。检索时限为建库至2024年1月。结果:共纳入文献28篇,其中临床决策2篇,指南3篇,系统评价17篇,专家共识6篇。最终提取总结出3个类别,10个条目,28条最佳证据内容;预康复开展条件有预康复团队、预康复人群、预康复时长、预康复场所;预康复风险管理涉及术前风险评估、戒烟戒酒、贫血筛查;预康复主要内容有营养管理、运动管理、心理认知管理。结论:医护人员应以肺癌预康复证据为临床指导,为患者制定个性化康复干预方案,提高患者参与度和满意度,进而推动证据的转化与应用。

Objective:To systematically summarize the best evidence on preoperative prehabilitation management of lung cancer,and to provide a reference basis for healthcare professionals to carry out preoperative prehabilitation clinical practice in order to improve the quality of preoperative prehabilitation management of lung cancer.Method:We systematically searched BMJ Best Practice,UpToDate,Joanna Briggs Institute(JBI)Evidence-Based Health Care Center,National Guideline Clearinghouse(NGC),National Institute for Health and Clinical Excellence(NICE),Registered Nurses'Association of Ontario,Guidelines International Network(GIN),New Zealand Guidelines Group,Yimaitong Guidelines Network,Cochrane Library,PubMed,Embase,China National Knowledge Infrastructure(CNKI),and Wanfang Database for evidence regarding preoperative prehabilitation of lung cancer.The search time limit was started from the establishment of the database to January,2024.Result:A total of 28 papers were included in the literature,including 2 clinical decisions,3 guidelines,17 systematic evaluations,and 6 expert consensus.We finally extracted and summarized 3 categories,10 entries,and 28 pieces of best evidence content.Prehabilitation conditions includes team,population,duration and place.Prehabilitation risk management involves preoperative risk assessment,smoking and alcohol cessation,and anemia screening.Prehabilitation key contents are nutritional management,exercise management and psycho-cognitive management.Conclusion:Healthcare professionals should use the evidence on lung cancer prehabilitation as a clinical guide and develop personalized rehabilitation interventions for patients to improve patient engagement and satisfaction,thereby promoting the translation and application of the evidence.