摘要
目的 检索并总结有关青少年特发性脊柱侧凸患者围手术期加速康复管理的最佳证据,旨在为相关科室医护人员提供循证依据.方法 根据"6S"证据模型,检索BMJ Best Practice、UpToDate、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library、国际指南协作网、英国国家临床医学研究所指南网、美国国立指南网、苏格兰校际指南网、加拿大安大略注册护士协会网站、CINAHL、PubMed、Embase、Web of Science、中国知网、医脉通、万方数据库、维普网、中国生物医学文献数据库等中英文数据库中有关青少年特发性脊柱侧凸患者围手术期加速康复管理的相关指南、专家共识、证据总结、系统评价等文献,检索时间为建库至2023年3月1日.由2名经过相关培训的研究者独立对获取文献进行质量评价和证据提取.结果 本研究共纳入18篇文献,其中指南2篇、专家共识4篇、系统评价2篇、证据总结2篇、随机对照试验3篇、类实验研究5篇,从术前管理、术中管理、术后并发症管理、功能锻炼4个方面共形成35条最佳证据.结论 本研究总结了青少年特发性脊柱侧凸患者围手术期加速康复管理的最佳证据,对临床医务人员开展加速康复管理具有指导意义.医护人员应基于加速康复理念制订康复护理措施,但仍需结合临床情景和患者意愿、谨慎地考虑证据的可行性,有选择地进行证据应用.
Abstract
Objective To retrieve and summarize the best evidence for perioperative enhanced rehabilitation in adolescent idiopathic scoliosis patients,with the aim of providing evidence-based basis for relevant medical and nursing staff.Methods Based on the"6S"evidence model,guideline,expert consensus,evidence summary,and systematic review of perioperative enhanced rehabilitation for adolescent idiopathic scoliosis patients were searched in British Medical Journal(BMJ)Best Practice,UpToDate,Joanna Briggs Institute Evidence-Based Health Care Center Database,Cochrane Library,Guidelines International Network,National Institute for Health and Clinical Excellence,National Guideline Clearinghouse,Scottish Intercollegiate Guidelines Network,Registered Nurses'Association of Ontario,CINAHL,PubMed,Embase,Web of Science,China National Knowledge Infrastructure,Medlive,WanFang Data,VIP,China Biomedical Medline Disc,and other Chinese and English databases.The search period was from database establishment to March 1,2023.Two trained researchers independently evaluated literature quality and extracted evidence.Results A total of 18 articles were included,including two guidelines,four expert consensus,two systematic reviews,two evidence summaries,three randomized controlled trials,and five quasi experimental studies.A total of 35 best evidence were formed from four aspects,namely preoperative management,intraoperative management,postoperative complication management,and functional exercise.Conclusions The best evidence for enhanced rehabilitation of adolescent idiopathic scoliosis patients during the perioperative period summarized has guiding signifiicance for clinical medical and nursing staff to carry out enhanced rehabilitation.Medical and nursing staff should develop rehabilitation nursing measures based on the concept of enhanced rehabilitation.However,it is still necessary to carefully consider the feasibility of the evidence and selectively apply it based on clinical scenarios and patient wishes.
NETL
NSTL
维普
万方数据