运动康复在血友病性关节病患者中应用的范围综述  

Exercise rehabilitation in patients with hemophilic arthropathy:a scoping review

作　　者：张文静 李魁星[2] 刘淑芬[3] 王书杰[2] 张艳彬[2] 陈文昆[2] ZHANG Wenjing;LI Kuixing;LIU Shufen;WANG Shujie;ZHANG Yanbin;CHEN Wenkun(Nursing Department,Peking Union Medical College Hospital,CAMS&PUMC,Beijing,100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院护理部,北京市100730 [2]中国医学科学院北京协和医学院北京协和医院血液内科 [3]中国医学科学院北京协和医学院北京协和医院康复医学科

出　　处：《中国护理管理》2024年第5期775-781,共7页Chinese Nursing Management

基　　金：中央高水平医院临床科研业务费资助(2022-PUMCH-B-046);北京协和医院护理科研课题(XHHLKY202201)。

摘　　要：目的:对运动康复在血友病性关节病患者中的应用进行范围综述,以期为医护人员开展相关工作提供参考。方法:按照范围综述的方法,系统检索国内外数据库从建库至2023年12月31日的相关文献,由2名研究者独立筛选并提取资料。结果:纳入24篇文献,年龄、出血情况、治疗方式及关节损伤程度为运动康复前的主要筛选条件。运动康复类型多为温和性运动,包括抗阻运动、柔韧性训练、有氧运动、本体感觉训练、关节松动和筋膜松解,且多种方式联合应用。强度趋于个体化进行,多为低、中强度,呈渐进式递增,频率和时间多为4~12周,1~3次/周,30~60min/次,并呈间歇性训练。效果评价涉及疼痛、出血、关节肌肉功能、活动能力、生活质量及心理状况6个方面。结论:运动康复在血友病性关节病患者中有积极效果,目前研究主要针对早期关节病变及出血维持稳定的患者,采用相对温和的运动,关于凝血因子替代治疗方案尚未达成共识。Objective:To conduct a scoping review of the exercise rehabilitation in patients with hemophilia arthropathy,and to provide a reference for healthcare professionals to carry out rehabilitation.Methods:According to the method of the scoping review,the relevant literature in databases at home and abroad was systematically searched from the establishment of the database to December 31,2023,and the data were independently screened and extracted by two researchers.Results:Twenty-four articles were included,and the age,bleeding conditions,treatments and degree of joint injury were the main screening criteria before exercise.The types of exercise were mostly mild,including resistance exercise,flexibility training,aerobic exercise,proprioceptive training,joint release and fascial release,and and a variety of exercises were combined.The intensity tended to be individualized,mostly in low and medium intensity,with progressive increments.The frequency and duration were mostly remained 4-12 weeks,1 to 3 times per week,30 to 60 min per time,and with a intermittent training way.The effect evaluation involved pain,bleeding,joint muscle function,mobility,quality of life and psychological status.Conclusion:Exercise rehabilitation has a positive effect in patients with hemophilia arthropathy.Current studies focus on relatively mild exercise in patients with early arthropathy and bleeding that is maintained stable.No consensus has been reached on a coagulation factor replacement regimen during this period.

关 键 词：运动康复 血友病性关节病 范围综述 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学] R554.1