手部烧伤患者手功能早期康复管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2025.08.017

摘要/Abstract

摘要：

目的总结手部烧伤患者手功能早期康复管理的最佳证据，为医护人员开展手部烧伤患者早期康复管理提供依据。方法依据5S模型，检索UpToDate、BMJ Best Practice、英国国家卫生与临床优化研究所网站、加拿大安大略省注册护士协会网站、国际指南网等中关于手部烧伤患者手功能早期康复的临床决策、指南、证据总结、专家共识、系统评价、Meta分析，证据总结、专家共识、指南检索时限为建库至2024年12月20日，系统评价的检索时限为2019年1月1日—2024年12月20日，对文献进行质量评价、证据提取、汇总，并依据2014版澳大利亚乔安娜布里格斯研究所证据预分级系统进行证据分级。结果共纳入17篇文献，包括1篇临床决策、4篇指南、6篇证据总结、3篇专家共识、3篇系统评价，总结了27条最佳证据，包括手部评估、手部摆放、水肿处理、敷料包扎、矫形器的使用、关节活动训练和健康教育7个方面。结论该研究总结了手部烧伤患者手功能早期康复管理的最佳证据，为临床制订康复管理方案提供了循证依据。医护人员可根据临床情境将相关证据应用于临床，以改善患者的手功能及生活质量。

关键词: 烧伤, 手功能, 康复护理, 证据总结, 循证护理学

Abstract:

Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn，and provide basis for medical personnel to carry out early rehabilitation management of hand burn. Methods According to the 5S model，all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate，BMJ Best Practice，NICE，RNAO，GIN，and so on. The retrieved evidence included clinical decisions，guidelines，evidence summaries，expert consensuses，systematic reviews，Meta analysis. The search period of the summary of best evidence, expert concensus and guidelines are from the establishment of the database to December 20，2024，and the search period of the systematic reviews is from January 1，2019 to December 20，2024. Quality evaluation of literature，evidence extraction and summary were conducted. The evidence was graded according to JBI evidence pre-grading system 2014. Results Totally 17 pieces of the literature were included，including 1 clinical decision，4 guidelines，6 evidence summaries，3 expert consensus articles，and 3 systematic reviews. Totally pieces of best evidence were summarized，including 7 aspects of assessment，hand positioning，treatment of edema，dressing，use of orthotics，joint mobility training，and health education. Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn，and provided evidence-based evidence for clinical rehabilitation management plan. According to the clinical situation，the medical staff can apply the evidence to clinical practice，so as to improve the hand function and quality of life of patients.

Key words: Burns, Hand Function, Rehabilitation Nursing, Evidence Summary, Evidence-Based Nursing

严雪芹, 曹松梅, 周芳芳, 朱丽群, 陈成, 朱梦雪, 张艳红, 梁怡青, 柏素萍. 手部烧伤患者手功能早期康复管理的最佳证据总结[J]. 中华护理杂志, 2025, 60(8): 998-1004.

YAN Xueqin, CAO Songmei, ZHOU Fangfang, ZHU Liqun, CHEN Cheng, ZHU Mengxue, ZHANG Yanhong, LIANG Yiqing, BAI Suping. Summary of best evidence for early rehabilitation management of hand function in patients with hand burns[J]. Chinese Journal of Nursing, 2025, 60(8): 998-1004.

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