下肢静脉溃疡患者体力活动的最佳证据总结

doi:10.3761/j.issn.0254-1769.2024.01.014

摘要/Abstract

摘要：

目的检索、评价和汇总下肢静脉溃疡患者体力活动的最佳证据，为临床下肢静脉溃疡患者体力活动干预提供循证依据。方法系统检索指南网站、数据库、专业协会网站中所有关于下肢静脉溃疡患者体力活动的相关文献，包括指南、临床决策、系统评价、证据总结、专家共识、随机对照研究，检索时限为建库至2023年5月19日。由2名研究者独立对纳入文献进行质量评价，并结合专业人士的判断，进行证据的提取与整合。结果共纳入18篇文献，包括指南6篇、临床决策2篇、系统评价6篇、专家共识3篇、随机对照研究1篇。最终形成26条最佳证据，包括活动时机、活动前评估、活动方式、活动时间及频率、活动强度、活动效果评价、质量控制、注意事项8个证据主题。结论该研究汇总了下肢静脉溃疡患者体力活动的最佳证据，建议护理人员在应用证据时结合具体实践条件和临床情景，根据患者的评估结果制订个性化的体力活动方案。

关键词: 下肢静脉溃疡, 体力活动, 证据总结, 循证护理学

Abstract:

Objective To retrieve，evaluate and summarize the best evidence of physical activity in patients with venous leg ulcer（VLU），and to provide the evidence for clinical practice of physical activity intervention for patients with VLU. Methods We systematically searched all relevant literature on the physical activity of patients with VLU，including clinical practice guidelines，clinical decision-making，systematic reviews，evidence summaries，expert consensuses，and original studies，from the guideline websites，databases，and professional association websites，with the search period from the database establishment to May 19，2023. 2 researchers independently evaluated the quality of the literature，and included and extracted and integrated evidence based on the judgment of professionals. Results A total of 18 articles were included，consisting of 6 guidelines，2 clinical decisions，6 systematic reviews，3 expert consensuses and 1 original study. Finally，26 pieces of best evidence were summarized，categorizing into 8 aspects which include timing of physical activity，patient assessment before physical activity，mode of physical activity，time and frequency of physical activity，intensity of physical activity，effect evaluation of physical activity，quality control and tips. Conclusion This study summarizes the best evidence of physical activity in patients with VLU. It is recommended that health care professionals should formulate individualized physical activity programs based on the practical conditions and clinical situation，and fully consider the evaluation results of patients.

Key words: Venous Leg Ulcers, Physical Activity, Evidence Summary, Evidence-Based Nursing

许志玮, 王娴, 穆文方, 王燕, 王安子. 下肢静脉溃疡患者体力活动的最佳证据总结[J]. 中华护理杂志, 2024, 59(1): 100-107.

XU Zhiwei, WANG Xian, MU Wenfang, WANG Yan, WANG Anzi. Summary of the best evidence for physical activity in patients with venous leg ulcer[J]. Chinese Journal of Nursing, 2024, 59(1): 100-107.

图/表 5

图1 文献筛选流程图注:NICE为英国国家卫生与临床优化研究所;SIGN为苏格兰院际指南协作网;RNAO为加拿大安大略省注册护士协会;GIN为国际指南协作网;NGC为美国国立指南网;WOCN为伤口造口失禁护理学会;WCET为世界造口治疗师协会。

Figure 1 Literature screening process

表1 纳入文献的一般特征（n=18）

Table 1 General characteristics of included literature（n=18）

表2 临床决策的方法学质量评价结果(n=2)

Table 2 Quality evaluation of clinical decisions(n=2)

表3 指南的质量评价结果(n=6)

Table 3 Quality evaluation of guidelines(n=6)

表4 下肢静脉溃疡患者体力活动的最佳证据

Table 4 Summary of best evidence for physical activity in patients with venous leg ulcers

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