择期胃肠道手术患者预康复的最佳证据总结

doi:10.3761/j.issn.0254-1769.2024.02.016

摘要/Abstract

摘要：

目的检索、评价并总结择期胃肠道手术患者预康复的最佳证据，为临床应用提供参考。方法计算机检索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、PubMed、CINAHL、Cochrane Library、中国知网、中国生物医学文献数据库、万方数据库和美国国立指南库、苏格兰校际指南网、英国国家卫生与临床优化研究所网站、新西兰指南协作网、加拿大安大略省注册护士协会网站、美国肿瘤护理协会网站、欧洲肠外肠内营养学会网站、美国肠外肠内营养学会网站、中国临床指南文库、医脉通指南网、中国抗癌协会网站、中华医学会肠外肠内营养学分会网站中关于择期胃肠道手术患者预康复的所有证据，包括指南、临床决策、专家共识、证据总结、系统评价、多中心的随机对照试验，检索时限为建库至2022年3月。由2名经过循证培训的研究者独立完成文献的质量评价，并听取循证专家的意见，对符合质量标准的文献进行证据提取及总结。结果共纳入21篇文献，其中6篇指南，8篇专家共识，2篇Meta分析和5篇系统评价，纳入文献的整体质量较高。从预康复的实施人员、营养支持、运动锻炼和心理干预4个方面汇总了22条最佳证据。结论该研究总结的择期胃肠道手术患者预康复的最佳证据具有一定的科学性和实用性，可为医护人员开展预康复提供依据。

关键词: 预康复, 胃肠道手术, 证据总结, 循证护理学

Abstract:

Objective To retrieve，evaluate and summarize the best evidence of prehabilitation interventions of patients undergoing elective gastrointestinal surgery，so as to provide references for clinical application. Methods All evidence on prehabilitation interventions of patients undergoing elective gastrointestinal surgery was retrieved from databases and websites including UpToDate，JBI Library，PubMed，CINAHL，Cochrane Library，CNKI，CBM，Wanfang and NGC，SIGN，NICE，NZGG，RNAO，ONS，ESPEN，CGC，CACA，CAMCSPEN. The retrieved evidence inclu-ded guidelines，clinical decisions，expert consensuses，evidence summaries，systematic reviews，randomized controlled trials，et al. The retrieval time limit was from the database construction to March，2022. Results Totally 21 articles were involved，including 6 guidelines，8 expert consensuses，2 meta-analyses and 5 systematic reviews. The overall quality of the included literature was high. Finally，22 pieces of best evidence about nutritional support，exercise training and psychological intervention were summarized. Conclusion The best evidence for prehabilitation intervention of patients undergoing elective gastrointestinal surgery summarized in this study is scientific and practical to a certain extent，which can provide bases for clinical workers to carry out prehabilitation clinical practice.

Key words: Prehabilitation, Gastrointestinal Surgery, Evidence Summary, Evidence-Based Nursing

台瑞, 方芳, 杨富, 余倩. 择期胃肠道手术患者预康复的最佳证据总结[J]. 中华护理杂志, 2024, 59(2): 236-243.

TAI Rui, FANG Fang, YANG Fu, YU Qian. Best evidence summary on prehabilitation interventions of patients undergoing elective gastrointestinal surgery[J]. Chinese Journal of Nursing, 2024, 59(2): 236-243.

图/表 6

图1 PubMed的文献检索策略

Figure 1 Literature search strategy of PubMed

图2 文献筛选流程图

Figure 2 Literature screening process

表1 纳入文献的一般特征（n=21）

Table 1 Basic characteristics of included studies（n=21）

表2 纳入指南的质量评价结果（n=6）

Table 2 Quality evaluation of included guidelines（n=6）

表3 纳入专家共识的质量评价结果（n=8）

Table 3 Quality evaluation of included expert consensuses（n=8）

表4 择期胃肠道手术患者预康复的最佳证据总结

Table 4 Best evidence for pre-habilitation interventions in patients undergoing elective gastrointestinal surgery

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