代谢相关脂肪性肝病患者运动管理的循证实践

doi:10.3761/j.issn.0254-1769.2025.01.010

摘要/Abstract

摘要：

目的剖析代谢相关脂肪性肝病患者运动管理证据转化过程中存在的问题，制订应对策略，评价最佳证据的应用效果。方法遵循证据转化模式，通过证据获取、基线审查、实践变革和效果评价4个阶段，将运动管理最佳证据应用于在福建省某三级甲等医院肝内科门诊就诊的代谢相关脂肪性肝病患者。比较基线审查（2023年3月—5月）、循证实践中期（2023年6月—8月）和循证实践后期（2023年9月—11月）护士对代谢相关脂肪性肝病患者运动管理审查指标的执行率、对相关知识的认知水平，患者的运动计划完成率、体重指数、肝脏硬度值、受控衰减参数及满意度。结果基线审查纳入88例患者，循证实践中期纳入95例患者，循证实践后期纳入107例患者。在循证实践中、后期，21个审查指标的执行率、护士对代谢相关脂肪性肝病患者运动管理相关知识的认知水平，以及患者的运动计划完成率、体重指数、受控衰减参数优于基线审查中的数值，差异均具有统计学意义（P<0.05）。结论应用代谢相关脂肪性肝病患者运动管理最佳证据，可提高护士对相关知识的认知水平、规范护理实践，同时可降低患者的体重指数、改善肝脂肪化程度。

Abstract:

Objective To analyze challenges in translating exercise management evidence for patients with metabolism-associated fatty liver disease（MAFLD），develop actionable strategies，and evaluate the application of best evidence. Methods Utilizing the evidence translation model，the best evidence was implemented for MAFLD patients in 4 phases：evidence acquisition，baseline practice review，intervention，and outcome evaluation. We compared the knowledge of exercise management evidence，implementation rates of review indicators，completion of exercise programs，BMI，liver stiffness measurement，controlled attenuation parameters，and patient satisfaction among medical staff at a tertiary hospital in Fujian Province during baseline（March-May 2023），mid-practice（June-August 2023），and late-practice（September-November 2023） phases. Results A total of 88 patients were included at baseline review，95 during mid-practice，and 107 in late-practice. Significant improvements were observed in the implementation rates of 21 review indicators，nurses’ knowledge，completion rate，BMI，and controlled attenuation parameters compared to the data at baseline（P<0.05）. Conclusion The application of best evidence in exercise management for MAFLD patients enhances nurses’ knowledge，standardizes nursing practices，and reduces patients’ BMI and controlled attenuation parameters.

Key words: Metabolic Associated Fatty Liver Disease, Nonalcoholic Fatty Liver Disease, Exercise, Evidence-Based Nursing

林菁菁, 王碧芬, 陈晓怡, 张雪玲, 傅婕, 林燕, 纪晓艳, 姚丽熙, 方艳, 林蓉金. 代谢相关脂肪性肝病患者运动管理的循证实践[J]. 中华护理杂志, 2025, 60(1): 69-76.

LIN Jingjing, WANG Bifen, CHEN Xiaoyi, ZHANG Xueling, FU Jie, LIN Yan, JI Xiaoyan, YAO Lixi, FANG Yan, LIN Rongjin. Evidence-based practices for exercise management in patients with metabolic associated fatty liver disease[J]. Chinese Journal of Nursing, 2025, 60(1): 69-76.

图/表 3

表1 代谢相关脂肪性肝病患者运动管理的审查指标

Table 1 Indicators for review of exercise management in patients with metabolism-related fatty liver disease

表2 护士对代谢相关脂肪性肝病患者运动管理审查指标的执行率比较

Table 2 Comparison of implementation rates of exercise management review indicators in patients

表3 3组代谢相关脂肪性肝病患者的体重指数、肝脏硬度值和受控衰减参数比较

Table 3 Comparison of BMI, liver stiffness measurement, controlled attenuation parameters among 3 groups

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