Background:Postoperative care has been evolving since the concept of enhanced recovery after surgery(ERAS)was introduced in China.This study aimed to evaluate the effects of early ambulation within 24h after unilatera...Background:Postoperative care has been evolving since the concept of enhanced recovery after surgery(ERAS)was introduced in China.This study aimed to evaluate the effects of early ambulation within 24h after unilateral total knee arthroplasty(TKA)on postoperative rehabilitation and costs in a Chinese population.Methods:This cohort study of patients with knee osteoarthritis who had undergone TKA at 24 large teaching hospitals between January 2014 and November 2016 involved 2687 patients who began ambulating within 24h(Group A)and 3761 patients who began ambulating later than 24h(Group B).The outcome measurements,such as length of stay(LOS),total hospitalization costs,dynamic pain level,knee flexion range of motion(ROM),results of the 12-Item Short Form Survey(SF-12),incidence of thromboembolic events and other complications,were recorded and compared.Results:The early ambulation group(Group A)had a shorter LOS and lower hospitalization costs and pain levels than the late ambulation group(Group B).There was a favorable effect in enhancing ROM for patients in Group A compared with patients in Group B.In Group A,patients had significantly higher postoperative SF-12 scores than those in Group B.The incidence of deep venous thrombosis(DVT)and pulmonary infection was significantly lower in Group A than in Group B.The incidence of pulmonary embolism(PE)and other complications did not differ between the two groups.Conclusions:Early ambulation within 24h after TKA was associated with reduced LOS,improved knee function,lower hospitalization costs and lower incidence of DVT and pulmonary infection in the Chinese population.展开更多
目的探讨经皮肾穿刺活检术患者早期下床活动的可行性和安全性。方法计算机检索CNKI、维普、万方、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science数据库,检索时限为自建库至2024年4月,纳入经皮肾穿刺活检...目的探讨经皮肾穿刺活检术患者早期下床活动的可行性和安全性。方法计算机检索CNKI、维普、万方、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science数据库,检索时限为自建库至2024年4月,纳入经皮肾穿刺活检术后患者早期活动和常规卧床的临床对照试验,进行质量评价后,采用Rev Man 5.3软件进行Meta分析。结果共纳入13篇文献,9篇为随机对照研究,4篇为临床对照研究,共2125例患者。Meta分析结果显示:与患者术后常规卧床相比,早期下床活动可以减少尿潴留的发生率[早期活动:51/368;常规卧床:151/559;RR=0.44,95%CI(0.22,0.91)]、腰背部不适感[早期活动:118/637;常规卧床:265/941;RR=0.52,95%CI(0.43,0.61)]和睡眠紊乱[早期活动:15/92;常规卧床:41/92;RR=0.37,95%CI(0.22,0.60)]。早期活动对患者肉眼血尿和肾周血肿发生率上并无显著差异,无统计学意义(P>0.05)。结论经皮肾穿刺活检术患者术后早期下床活动不增加肉眼血尿、肾周血肿的发生风险,但可以减少术后尿潴留的发生,增进患者的舒适度。展开更多
目的系统评价经桡动脉行冠状动脉介入术患者术后早期下床活动的效果。方法检索1993年1月1日至2023年12月31日发表在Cochrane Library、PubMed、Web of Science、Embase、中国知网、中国生物医学文献数据库、维普资讯网、万方数据库和国...目的系统评价经桡动脉行冠状动脉介入术患者术后早期下床活动的效果。方法检索1993年1月1日至2023年12月31日发表在Cochrane Library、PubMed、Web of Science、Embase、中国知网、中国生物医学文献数据库、维普资讯网、万方数据库和国内外临床试验注册中心有关经桡动脉行冠状动脉介入术后早期下床活动的试验性研究,对纳入研究进行质量评价,采用RevMan 5.3软件进行Meta分析。结果最终纳入12项研究,Meta分析结果显示,与常规康复相比,经桡动脉行冠状动脉介入术后早期下床活动有利于改善患者左室射血分数[MD=4.35,95%CI(1.96,6.74),P<0.01];能提高患者生活质量[SMD=2.56,95%CI(1.37,3.75),P<0.01];增强患者日常生活能力[MD=3.78,95%CI(1.87,5.69),P<0.01];降低心绞痛[OR=0.35,95%CI(0.16,0.79),P=0.01]、心律失常[OR=0.33,95%CI(0.15,0.70),P<0.01]和心力衰竭[OR=0.35,95%CI(0.13,0.91),P=0.03]发生率;对改善冠状动脉再狭窄[OR=0.28,95%CI(0.07,1.16),P=0.08],左室舒张末内径[MD=-1.53,95%CI(-4.58,1.53),P=0.33]和6分钟步行距离[MD=32.87,95%CI(-2.03,67.77),P=0.06]效果不显著。结论早期下床活动可以明显改善经桡动脉行冠状动脉介入术后患者的心功能,提高其生活质量和日常生活能力,减少并发症,促进患者的康复。展开更多
目的:对早期活动在腰椎融合手术病人中的应用进行范围综述,为临床实践及相关研究提供参考。方法:系统检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网、中国生物医学文献服务系统中的相关文献,检索时限从建库至202...目的:对早期活动在腰椎融合手术病人中的应用进行范围综述,为临床实践及相关研究提供参考。方法:系统检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网、中国生物医学文献服务系统中的相关文献,检索时限从建库至2022年11月30日,由2名研究者独立筛选文献和提取数据。结果:共纳入19篇文献,从手术类型、早期活动方案、评价指标等方面对腰椎融合术后早期活动相关内容进行分析及整合。结论:腰椎融合术后病人早期下床活动时机未明确,活动方案及其评价指标存在异质性,今后应制定系统全面且科学的个性化早期下床活动方案,以促进病人术后康复及满意度。展开更多
Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to Au...Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to August 2020,ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge,attitudes and perceptions of ICU early mobilization.Results Totally 512 nurses completed the questionnaire.The respondents’mean score for knowledge of early mobilization was 6.89±2.91.The level of knowledge was good in 2.5%(13/512),fair in 52.3%(268/512).The attitudes toward early mobilization were positive in 31.4%(161/512).In terms of perceived implementation of ICU early mobilization,42.9%(220/512)of nurses did not believe that this should be a top priority in intensive care.The attitudes of nurses from different ICUs were significantly different(F=3.58,P<0.05).The knowledge(7.34±2.78 vs.6.49±2.97,t=3.37,P<0.001)and attitudes(3.82±0.58 vs.3.52±0.56,t=5.63,P<0.001)of nurses who had early mobilization related training were higher than those of nurses who had no training.Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers.However,there is still a gap in the knowledge,attitudes and perceptions of ICU early mobilization among nurses.In future studies,it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps.Meanwhile,more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.展开更多
基金the National Health and Family Planning Commission of the People’s Republic of China(CN)program(201302007).
文摘Background:Postoperative care has been evolving since the concept of enhanced recovery after surgery(ERAS)was introduced in China.This study aimed to evaluate the effects of early ambulation within 24h after unilateral total knee arthroplasty(TKA)on postoperative rehabilitation and costs in a Chinese population.Methods:This cohort study of patients with knee osteoarthritis who had undergone TKA at 24 large teaching hospitals between January 2014 and November 2016 involved 2687 patients who began ambulating within 24h(Group A)and 3761 patients who began ambulating later than 24h(Group B).The outcome measurements,such as length of stay(LOS),total hospitalization costs,dynamic pain level,knee flexion range of motion(ROM),results of the 12-Item Short Form Survey(SF-12),incidence of thromboembolic events and other complications,were recorded and compared.Results:The early ambulation group(Group A)had a shorter LOS and lower hospitalization costs and pain levels than the late ambulation group(Group B).There was a favorable effect in enhancing ROM for patients in Group A compared with patients in Group B.In Group A,patients had significantly higher postoperative SF-12 scores than those in Group B.The incidence of deep venous thrombosis(DVT)and pulmonary infection was significantly lower in Group A than in Group B.The incidence of pulmonary embolism(PE)and other complications did not differ between the two groups.Conclusions:Early ambulation within 24h after TKA was associated with reduced LOS,improved knee function,lower hospitalization costs and lower incidence of DVT and pulmonary infection in the Chinese population.
文摘目的探讨经皮肾穿刺活检术患者早期下床活动的可行性和安全性。方法计算机检索CNKI、维普、万方、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science数据库,检索时限为自建库至2024年4月,纳入经皮肾穿刺活检术后患者早期活动和常规卧床的临床对照试验,进行质量评价后,采用Rev Man 5.3软件进行Meta分析。结果共纳入13篇文献,9篇为随机对照研究,4篇为临床对照研究,共2125例患者。Meta分析结果显示:与患者术后常规卧床相比,早期下床活动可以减少尿潴留的发生率[早期活动:51/368;常规卧床:151/559;RR=0.44,95%CI(0.22,0.91)]、腰背部不适感[早期活动:118/637;常规卧床:265/941;RR=0.52,95%CI(0.43,0.61)]和睡眠紊乱[早期活动:15/92;常规卧床:41/92;RR=0.37,95%CI(0.22,0.60)]。早期活动对患者肉眼血尿和肾周血肿发生率上并无显著差异,无统计学意义(P>0.05)。结论经皮肾穿刺活检术患者术后早期下床活动不增加肉眼血尿、肾周血肿的发生风险,但可以减少术后尿潴留的发生,增进患者的舒适度。
文摘目的系统评价经桡动脉行冠状动脉介入术患者术后早期下床活动的效果。方法检索1993年1月1日至2023年12月31日发表在Cochrane Library、PubMed、Web of Science、Embase、中国知网、中国生物医学文献数据库、维普资讯网、万方数据库和国内外临床试验注册中心有关经桡动脉行冠状动脉介入术后早期下床活动的试验性研究,对纳入研究进行质量评价,采用RevMan 5.3软件进行Meta分析。结果最终纳入12项研究,Meta分析结果显示,与常规康复相比,经桡动脉行冠状动脉介入术后早期下床活动有利于改善患者左室射血分数[MD=4.35,95%CI(1.96,6.74),P<0.01];能提高患者生活质量[SMD=2.56,95%CI(1.37,3.75),P<0.01];增强患者日常生活能力[MD=3.78,95%CI(1.87,5.69),P<0.01];降低心绞痛[OR=0.35,95%CI(0.16,0.79),P=0.01]、心律失常[OR=0.33,95%CI(0.15,0.70),P<0.01]和心力衰竭[OR=0.35,95%CI(0.13,0.91),P=0.03]发生率;对改善冠状动脉再狭窄[OR=0.28,95%CI(0.07,1.16),P=0.08],左室舒张末内径[MD=-1.53,95%CI(-4.58,1.53),P=0.33]和6分钟步行距离[MD=32.87,95%CI(-2.03,67.77),P=0.06]效果不显著。结论早期下床活动可以明显改善经桡动脉行冠状动脉介入术后患者的心功能,提高其生活质量和日常生活能力,减少并发症,促进患者的康复。
文摘目的:对早期活动在腰椎融合手术病人中的应用进行范围综述,为临床实践及相关研究提供参考。方法:系统检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网、中国生物医学文献服务系统中的相关文献,检索时限从建库至2022年11月30日,由2名研究者独立筛选文献和提取数据。结果:共纳入19篇文献,从手术类型、早期活动方案、评价指标等方面对腰椎融合术后早期活动相关内容进行分析及整合。结论:腰椎融合术后病人早期下床活动时机未明确,活动方案及其评价指标存在异质性,今后应制定系统全面且科学的个性化早期下床活动方案,以促进病人术后康复及满意度。
基金This project is supported by the Fundamental Research Funds for the Central Universities(Project number:3332019171).
文摘Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to August 2020,ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge,attitudes and perceptions of ICU early mobilization.Results Totally 512 nurses completed the questionnaire.The respondents’mean score for knowledge of early mobilization was 6.89±2.91.The level of knowledge was good in 2.5%(13/512),fair in 52.3%(268/512).The attitudes toward early mobilization were positive in 31.4%(161/512).In terms of perceived implementation of ICU early mobilization,42.9%(220/512)of nurses did not believe that this should be a top priority in intensive care.The attitudes of nurses from different ICUs were significantly different(F=3.58,P<0.05).The knowledge(7.34±2.78 vs.6.49±2.97,t=3.37,P<0.001)and attitudes(3.82±0.58 vs.3.52±0.56,t=5.63,P<0.001)of nurses who had early mobilization related training were higher than those of nurses who had no training.Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers.However,there is still a gap in the knowledge,attitudes and perceptions of ICU early mobilization among nurses.In future studies,it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps.Meanwhile,more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.
