全膝关节置换患者康复功能锻炼的最佳证据总结  

Summary of best evidence for rehabilitation functional exercise in patients undergoing total knee arthroplasty

作　　者：王彦艳[1] 姚梁怡 陈鑫[2] 乔改红[1] 王静[1] 韩娜[1] Wang Yanyan;Yao Liangyi;Chen Xin;Qiao Gaihong;Wang Jing;Han Na(Department of Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;School of Nursing and Health,Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院外科医学部,郑州450000 [2]郑州大学护理与健康学院,郑州450000

出　　处：《中华现代护理杂志》2023年第32期4409-4416,共8页Chinese Journal of Modern Nursing

基　　金：河南省教育厅高等学校重点科研项目(23B320008)。

摘　　要：目的检索国内外全膝关节置换术(TKA)患者康复功能锻炼的相关证据,并对最佳证据进行总结,为构建TKA患者康复功能锻炼管理方案提供依据。方法采用PIPOST构建循证护理问题,计算机检索澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心数据库、BMJ Best Practice、Embase、UpToDate、Web of Science、Cochrane Library、PubMed、美国运动医学会网站、英国国家临床优化研究所、中国知网、万方医学网、中国生物医学文献数据库中关于TKA患者康复功能锻炼的所有证据,以"全膝关节置换术/膝关节置换""功能训练/锻炼/力量训练/恢复/康复"为中文检索词,以"knee replacement/knee arthroplasty""functional training/exercise/strength training/early mobilization/recovery/rehabilitation"为英文检索词,文献类型包括指南、系统评价、证据总结、专家共识、临床决策、随机对照试验(RCT),检索时限均为建库至2023年1月10日。由2名经过循证护理培训的研究者独立完成文献质量评价,并结合专业人员的判断,对符合质量标准的文献进行证据提取和总结。结果共纳入11篇文献,其中指南4篇、系统评价4篇、RCT研究2篇、临床决策1篇。从多学科组织管理、预康复锻炼、康复功能锻炼方案、延续性功能锻炼和锻炼依从性5个方面汇总了26条最佳证据。结论本研究总结的关于TKA患者康复功能锻炼的最佳证据可为医护人员制订管理方案提供依据,医护人员在应用证据时需要考虑临床实际、患者自身状况及意愿,制订针对性的康复功能锻炼方案。Objective To retrieve the evidence on rehabilitation functional exercise for total knee arthroplasty(TKA)patients both domestically and internationally,and summarize the best evidence to provide a basis for constructing a management plan of rehabilitation functional exercise for TKA patients.Methods Using population,intervention,professional,outcome,setting and type of evidence(PIPOST)to construct evidence-based nursing issues,all evidence on rehabilitation functional exercise for TKA patients was searched through computers in the Joanna Briggs Institute(JBI)Evidence-Based Health Care Center in Australia,British Medical Journal(BMJ)Best Practice,Embase,UpToDate,Web of Science,Cochrane Library,PubMed,American College of Sports Medicine,National Institute for Health and Clinical Excellence,China National Knowledge Infrastructure,WanFang Data and China Biomedical Literature Database.The Chinese and English search terms were"knee replacement/knee arthroplasty"and"functional training/exercise/strength training/early mobilization/recovery/rehabilitation".The types of literature included guidelines,systematic reviews,summary of evidence,expert consensus,clinical decision-making,and randomized controlled trials(RCTs).The search period was from the establishment of the database to January 10,2023.Two researchers trained in evidence-based nursing independently completed the literature quality evaluation,and combined with professional judgment,extracted and summarized evidence for literature that met quality standards.Results A total of 11 articles were included,including 4 guidelines,4 systematic reviews,2 RCTs,and 1 clinical decision-making.A total of 26 best evidence pieces were summarized from 5 aspects,namely multidisciplinary organizational management,pre-rehabilitation exercise,rehabilitation functional exercise plan,continuous function exercise,and exercise compliance.Conclusions The best evidence summarized regarding rehabilitation functional exercise for TKA patients can provide a basis for medical and nursing sta

关 键 词：康复 关节置换 膝 功能锻炼 证据总结 循证护理 

分 类 号：R473.6[医药卫生—护理学]