重度特发性脊柱侧凸患者肺康复的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.14.013

摘要/Abstract

摘要：

目的检索并获取重度特发性脊柱侧凸患者规范化肺康复管理策略的相关证据，并对最佳证据进行总结。方法系统检索国内外相关指南网站、PubMed、Embase、Web of Science、中国知网、万方数据库等中与重度特发性脊柱侧凸患者肺康复管理相关的文献，包括最佳实践、指南、专家共识、证据总结、系统评价，检索时限为建库至2023年1月30日。由2名研究者独立对文献质量进行评价并提取资料。结果最终纳入14篇文献，包括2篇最佳实践、3篇指南、5篇专家共识、4篇系统评价。从肺康复的明确目标、多学科专业化团队、肺康复的最佳时机、术前肺康复策略、术中肺保护策略、术后肺康复策略、全程综合性干预7个维度归纳了25条最佳证据。结论该研究总结了重度特发性脊柱侧凸患者肺康复管理的最佳证据，具有一定的科学性与全面性，可为制订特发性重度脊柱侧凸患者肺康复评估和管理方案、实践标准提供循证依据。

关键词: 特发性脊柱侧凸, 肺康复, 呼吸, 循证护理学

Abstract:

Objective To retrieve and obtain the relevant evidence of standardized pulmonary rehabilitation strategies for patients with severe idiopathic scoliosis，and to summarize the best evidence. Methods We searched relevant guideline networks，PubMed，Embase，Web of Science，CNKI，Wanfang databases to collect relevant guidelines，expert consensuses，best practices，recommended practices and systematic evaluations related to pulmonary rehabilitation management in severe idiopathic scoliosis from the establishment of the database to January 30，2023. There were 2 researchers who independently evaluated the literature quality and extracted data. Results A total of 14 articles were included，including 2 best practices，3 guidelines，5 expert consensuses，4 systematic reviews，and 25 pieces of best evidence were summarized from 7 dimensions，namely clear objective of pulmonary rehabilitation，multidisciplinary team management，optimal timing of pulmonary rehabilitation，preoperative pulmonary rehabilitation strategy，intraoperative pulmonary protection strategy，postoperative pulmonary rehabilitation strategy，and compre-hensive intervention. Conclusion This study summarized the best evidence of pulmonary rehabilitation management for patients with severe idiopathic scoliosis，and it has a certain scientific and comprehensive nature，which can provide evidence-based bases for the formulating of pulmonary rehabilitation evaluation and management programs and practice standards for patients with severe idiopathic scoliosis.

Key words: Idiopathic Scoliosis, Pulmonary Rehabilitation, Breathing, Evidence-Based Nursing

马姚静, 王鑫鑫, 余群飞, 支小燕, 王文霞, 任英, 吴岩, 赵锐祎. 重度特发性脊柱侧凸患者肺康复的最佳证据总结[J]. 中华护理杂志, 2023, 58(14): 1758-1765.

MA Yaojing, WANG Xinxin, YU Qunfei, ZHI Xiaoyan, WANG Wenxia, REN Ying, WU Yan, ZHAO Ruiyi. Evidence summary of pulmonary rehabilitation in patients with severe idiopathic scoliosis[J]. Chinese Journal of Nursing, 2023, 58(14): 1758-1765.

图/表 5

图1 文献筛选流程图

Figure 1 Flow chart of literature screening

表1 纳入文献的一般情况（n=14）

Table 1 Information of included articles（n=14）

表2 纳入指南的质量评价结果（n=3）

Table 2 Quality evaluation results of guidelines（n=3）

表3 纳入专家共识和最佳实践的质量评价结果（n=7）

Table 3 Quality evaluation results of expert consensuses and best practices（n=7）

表4 重度特发性脊柱侧凸患者肺康复的证据总结

Table 4 Summary of evidence for pulmonary rehabilitation in patients with severe idiopathic scoliosis

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