膝关节置换术后患者冷疗应用的最佳证据总结  

Summary of the best evidence of cold therapy for patients after knee joint replacement

作　　者：马燕飞 宁宁[2] 周宗科[2] 李叶萍 陈佳丽[2] 付中敏 侯爱琳 王春艳 胡蓉 Ma Yanfei;Ning Ning;Zhou Zongke;Li Yeping;Chen Jiali;Fu Zhongmin;Hou Ailin;Wang Chunyan;Hu Rong(Department of Orthopedics,Mianyang Hospital Affiliated to University of Electronic Science and Technology of China&Mianyang Central Hospital,Mianyang 621000,China;Department of Orthopedics,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院骨科,绵阳621000 [2]四川大学华西医院骨科,成都610041

出　　处：《中华现代护理杂志》2023年第24期3283-3290,共8页Chinese Journal of Modern Nursing

基　　金：四川省科技厅重点研发项目(2021YFS0068);四川大学华西医院学科发展专项基金(HXHL20003)。

摘　　要：目的总结膝关节置换术后患者冷疗应用的相关证据,以期为临床工作中膝关节置换术后患者冷疗的实际开展提供部分理论支持。方法系统检索国内外相关数据库及网站关于膝关节置换术后患者冷疗的文献,检索时间为建库至2022年9月,文献质量评价及证据提取由2名研究者独立完成。结果本研究共计纳入文献17篇,其中临床实践指南2篇,系统评价5篇,随机对照试验6篇,专家共识4篇,2名研究者独立评价并提取证据后,共汇总评估与宣教、冷疗观察、冷疗工具、冷疗参数及冷疗效果5个方面的19条证据,其中A级推荐证据8条,B级证据推荐11条。结论膝关节置换术后患者冷疗正被广泛接受与应用,医务人员应以患者安全为前提,结合患者个体差异、患者意愿、实际临床场景、医疗设备差异、医务人员技术水平、成本效益等多方面因素制定科学的冷疗方案,实现患者利益最大化。Objective To summarize the evidence of cold therapy for patients after knee joint replacement,so as to provide theoretical support for the practical implementation of cold therapy in patients after knee joint replacement in clinical practice.Methods The literature on cold therapy for patients after knee joint replacement was systematically searched in relevant databases and websites at home and abroad.The search period was from database establishment to September 2022.The evaluation of literature quality and evidence extraction were independently completed by two researchers.Results A total of 17 articles were included,including two clinical practice guidelines,five systematic reviews,six randomized controlled trials,and four expert consensuses.After independent evaluation and evidence extraction by two researchers,a total of 19 pieces of evidence were collected from 5 aspects:evaluation and education,observation of cold therapy,cold therapy tools,cold therapy parameters,and cold therapy effects.Among them,8 pieces of A-level recommended evidence and 11 pieces of B-level recommended evidence.Conclusions Cold therapy for patients after knee joint replacement is widely accepted and applied.Medical and nursing personnel should prioritize patient safety and formulate scientific cold therapy plans based on various factors such as individual differences,patient preferences,actual clinical scenarios,differences in medical equipment,medical and nursing personnel technical level,and cost-effectiveness,in order to maximize patient benefits.

关 键 词：关节成形术 置换 膝 冷疗 循证护理 

分 类 号：R473.6[医药卫生—护理学]