摘要
目的 总结结直肠癌手术患者术前预康复管理的相关证据,为临床实施术前预康复策略提供依据.方法 依据"6 S"金字塔证据模型,系统检索国内外中英文数据库及相关专业网站,检索时限为 2012 年 1 月 1 日-2022 年6 月 30 日.由 2 名研究者独立完成文献质量评价和资料提取,对符合质量标准的文献进行证据提取和整合.结果 共纳入相关文献 21 篇,其中指南 6 篇、证据总结 2 篇、推荐实践 1 篇、临床决策 3 篇、系统评价 4 篇、专家共识 3 篇、随机对照试验 2 篇.最终形成包括术前风险评估、营养管理、贫血管理、康复训练、预防性抗血栓管理、心理干预 6个方面的 26 条证据.结论 本研究汇总结直肠癌患者术前预康复策略的证据,旨在优化结直肠癌患者术前的功能状态,减少术后并发症的发生,以促进患者术后康复.建议在证据转化时结合临床实践,且考虑每条证据的可行性和适宜性,建立结直肠癌患者术前预康复管理体系.
Abstract
Objective To summarize the relevant evidence of preoperative pre-habilitation management of patients undergoing colorectal cancer surgery,so as to provide references for clinical practice.Methods According to the＂6 S＂pyramid evidence model,the preoperative pre-habilitation management of patients undergoing colorectal cancer surgery was systematically searched in domestic and foreign databases and related professional websites,with the time setting between January 1,2012 to June 30,2022.Evidence evaluation and extraction were conducted by two independent researchers.Results Twenty-one articles were found,including 6 guidelines,2 evidence summaries,1 recommended practice,3 clinical decisions,4 systematic reviews,3 expert consensuses,and 2 randomized controlled trials.A total of 26 pieces of best evidence were integrated into six dimensions of preoperative risk assessment,nutritional management,anemia management,rehabilitation training,preventive antithrombotic therapy and psychological intervention.Conclusion This study summarized the evidence of preoperative pre-rehabilitation strategies for patients with colorectal cancer,aiming to optimize their preoperative functional status,reduce the occurrence of postoperative complications,and promote their postoperative rehabilitation.It is recommended to establish a pre-operation rehabilitation management system for such patients considering the clinical environment and the feasibility and suitability of each piece of evidence.
基金项目
河南省医学科技攻关计划联合共建项目(2021)(LHGJ20210220)
NETL
NSTL
万方数据