全膝关节置换围手术期下肢肿胀预防与管理的证据总结  

Evidence summary for the prevention and management of perioperative lower limb swelling after total knee arthroplasty

作　　者：苏宙 真启云[1] 戴婷婷 瞿辉武 崔莉莉 王嘉玮 SU Zhou;ZHEN Qiyun;DAI Tingting;QU Huiwu;CUI Lili;WANG Jiawei(Department of Orthopedics,People's Hospital of Jiangsu Universiy,Zhenjiang,Jiangsu province,212002,China)

机构地区：[1]江苏大学附属人民医院骨科,江苏省镇江市212002 [2]宜兴市第五人民医院骨科

出　　处：《中国护理管理》2024年第12期1868-1874,共7页Chinese Nursing Management

基　　金：镇江市第一人民医院临床研究专项课题(Y2022005);无锡市科学技术协会软科学研究课题(KX-24-B82)。

摘　　要：目的:总结全膝关节置换围手术期患者下肢肿胀预防与管理的相关证据,为临床制订全膝关节置换围手术期患者下肢肿胀护理干预策略提供循证依据。方法:计算机检索国内外相关指南网、骨科协会网站及数据库等关于全膝关节置换围手术期患者下肢肿胀管理的文献,包括临床实践指南、临床决策、专家共识、系统评价、证据总结及相关原始研究,检索时限为建库至2024年9月30日。由2名研究员独立选择纳入的文献,进行文献质量评价和提取证据资料。结果:共纳入16篇文献,其中指南3篇、临床决策1篇、系统评价5篇、专家共识5篇、随机对照试验2篇。总结了包括术前预处理、失血预防策略、康复运动管理、下肢肿胀护理及延续护理共5个方面的18条证据。结论:总结的关于全膝关节置换围手术期下肢肿胀预防与管理的证据可指导医护人员结合临床实际情况制订相应的干预方案,改善患者的康复结局。Objective:To summarize the evidence for the prevention and management of perioperative lower limb swelling in patients undergoing total knee arthroplasty.Methods:A comprehensive search was conducted for relevant articles on the prevention and management of perioperative lower limb swelling after total knee arthroplasty,including clinical practice guidelines,clinical decision-making,expert consensus,systematic review,evidence summary and related original research.Sources were guideline websites,orthopedic association websites,and databases.The search time limit was from the establishment of the database to September 30,2024.The included articles were independently selected by two researchers to evaluate their quality and extract evidence.Results:A total of 16 articles were included,including 3 guidelines,1 clinical decision-making,5 systematic reviews,5 expert consensus and 2 randomized controlled studies.Totally 18 pieces of evidence were summarized from 5 aspects,including preoperative pretreatment,blood loss prevention strategy,rehabilitation exercise management,lower limb swelling care and continuous care.Conclusion:The summary of the evidence for the prevention and management of perioperative lower limb swelling after total knee arthroplasty can guide professionals to formulate corresponding intervention programs according to the clinical situation and improve the rehabilitation outcomes of patients.

关 键 词：全膝关节置换 肿胀 管理 循证护理学 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]