Abstract:

Objective To retrieve,evaluate and summarize the best evidence of resistance training for breast cancer-related lymphedema.Methods We searched BMJ Best Practice,UpToDate,Registered Nurses’ Association of Ontario（RNAO）,National Comprehensive Cancer Network（NCCN）,National Institute for Health and Clinical Excel-lence（NICE）,Scottish Intercollegiate Guidelines Network（SIGN）,Medive,PubMed,CINAHL,Cochrane library,Joanna Briggs Institute（JBI） COnNECT+,CNKI,Wanfang,National Lymphedema Network（NLN）,International Society of Lymphology（ISL） to collect relevant guidelines,evidence summaries,recommended practice,systematic reviews and expert consensuses published from database construction to September 1st of 2020. 2 researchers evaluated the quality of various literature,and extracted recommendations and research conclusions from the included literature.Results Totally 21 articles were involved,including 1 guideline,14 systematic reviews,2 expert consensuses,1 recommended practice and 3 evidence summaries. Finally,23 pieces of best evidence about contraindications,timing of training,training forms,training intensity and training effectiveness were summarized.Conclusion Resistance training combined with individualized exercises,professional guidance and regular monitoring management is safe and beneficial. Clinical staff should develop resistance training program based on clinical environment as well as patient’s individual situation and training conditions.

Key words: Breast Neoplasm, Lymphedema, Resistance Training, Evidence-Based Nursing

摘要：

目的 检索、评价和汇总乳腺癌相关淋巴水肿患者抗阻力训练的最佳证据,为临床开展乳腺癌相关淋巴水肿抗阻力训练干预提供循证依据。方法 检索BMJ Best Practice、UpToDate、加拿大安大略护士学会网站、美国国家综合癌症网络、英国国立健康与临床优化研究所、苏格兰学院指南网、医脉通、PubMed、CINAHL、Cochrane Library、Joanna Briggs Institute COnNECT+、中国知网、万方数据平台、国际淋巴水肿网站、国际淋巴水肿协会网站内关于乳腺癌相关淋巴水肿患者抗阻力训练的所有证据,包括指南、证据总结、临床决策、最佳实践信息册、系统评价、专家共识,检索时限为建库至2020年9月1日。由2名研究者对文献质量进行评价和资料提取。结果 共纳入21篇文献,其中1篇指南,14篇系统评价,2篇专家共识,1篇最佳实践信息册,3篇证据总结。从禁忌证、开始时间、训练形式、训练强度、训练效果、注意事项6个方面,共提取23条最佳证据。结论 结合个体化锻炼、专业人员指导、定期监测管理的抗阻力训练,对乳腺癌相关淋巴水肿患者是安全且有益的。医护人员应结合临床特点和工作环境,同时考虑患者的个体情况及锻炼条件,为患者制订个性化的抗阻力训练方案,从而确保训练依从性、安全性和有效性。

关键词: 乳腺肿瘤, 淋巴水肿, 抗阻力训练, 循证护理学