摘要
目的:提取并归纳颈椎前路手术患者术后早期下床活动的最佳证据,为临床患者早期下床活动提供实践依据。方法:按照PIPOST模型提出研究问题,依据"6S"模型系统检索了UpToDate、BMJ最佳实践网站、Cochrane Library、中国知网、万方等数据库中与"颈椎前路手术患者术后早期活动"相关的临床指南、专家共识、临床决策、证据总结、系统评价及随机对照试验。检索时间为建库至2022年2月1日。由2名研究员对文献的质量进行独立评价,对符合质量标准的文献进行证据提取和整合。结果:共纳入文献10篇,包含指南2篇、专家共识3篇、系统评价3篇、随机对照试验2篇。归纳为28条证据7个维度,分别为多学科团队合作、优化术前健康宣教、下床活动前准备、下床活动内容、多模式镇痛管理、恶心呕吐管理、下床活动安全管理。结论:本研究所纳入的证据为颈椎前路术后患者实施早期下床活动提供了系列信息。医护人员需将证据与临床实际情况相结合,考虑患者的价值与期望,全面、个体化地评估患者后制作早期下床活动方案。
Objective To extract and summarize the best evidence of early ambulation after anterior cervical surgery,so as to provide practical basis for early ambulation of clinical patients.Methods The research questions were proposed based on the population,intervention,professional,outcome,setting and type of evidence(PIPOST)model.According to the"6S"model,the clinical guidelines,expert consensus,clinical decision-making,evidence summary,systematic reviews and randomized controlled trials related to"early postoperative activities of patients undergoing anterior cervical surgery"in databases such as UpToDate,British Medical Journal(BMJ)Best Practice website,Cochrane Library,China National Knowledge Infrastructure and WanFang Data were systematically retrieved.The retrieval time was from the establishment of the database to February 1,2022.Two researchers independently evaluated the quality of the articles,and extracted and integrated the evidence of the articles meeting the quality standards.Results A total of 10 articles were included,including two guidelines,three expert consensus,three systematic reviews,and two randomized controlled trials.It is summarized into 28 pieces of evidence and 7 dimensions,including multidisciplinary team cooperation,optimization of preoperative health education,preparation before ambulation,content of ambulation,multimodal analgesia management,nausea and vomiting management,and safety management of ambulation.Conclusions The evidence included in this study provides a series of information for early ambulation after anterior cervical surgery.The medical and nursing staff should combine the evidence with the actual clinical situation,consider the value and expectation of the patient,comprehensively and individually evaluate the patient,and then make an early ambulation plan.
作者
雷蕾
陈佳丽
宁宁
刘浩
丁琛
孟阳
袁秀蓉
胡蓉
Lei Lei;Chen Jiali;Ning Ning;Liu Hao;Ding Chen;Meng Yang;Yuan Xiurong;Hu Rong(Department of Orthopedics,West China Hospital of Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610041,China)
出处
《中华现代护理杂志》
2023年第9期1238-1244,共7页
Chinese Journal of Modern Nursing
关键词
颈椎病
颈椎前路手术
加速康复外科
早期下床活动
Cervical spondylopathy
Anterior cervical surgery
Enhanced recovery after surgery
Early ambulation
