主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2020, Vol. 20 ›› Issue (5): 724-730.doi: 10.3969/j.issn.1672-1756.2020.05.017

• 循证护理 • 上一篇    下一篇

ICU成人机械通气患者早期康复运动最佳证据总结及临床评价

付贞艳 张霞 胡雁 江智霞 陈德友 王雨 李晓娟 苟贤娟 权明桃   

  1. 遵义医科大学附属医院新生儿科,563000 贵州省遵义市(付贞艳);综合ICU(张霞,陈德友,王雨,李晓娟,苟贤娟);护理部(江智霞,权明桃);复旦大学护理学院(胡雁)
  • 出版日期:2020-05-15 发布日期:2020-05-15
  • 通讯作者: 胡雁,博士,教授,院长,E-mail:huyan@fudan.edu.cn;权明桃,硕士,主任护师,教育科科长,E-mail:865768818@qq.com
  • 作者简介:付贞艳,硕士在读,护师
  • 基金资助:
    2019年复旦循证护理中心证据转化与临床应用项目

Clinical evaluation of early rehabilitation exercise for adult patients with mechanical ventilation in ICU: a systematic review and best evidence synthesis

FU Zhenyan, ZHANG Xia, HU Yan, JIANG Zhixia, CHEN Deyou, WANG Yu, LI Xiaojuan, GOU Xianjuan, QUAN Mingtao   

  1. Neonatal Department, Affiliated Hospital of Zunyi Medical University, Guizhou province, 563000, China
  • Online:2020-05-15 Published:2020-05-15
  • Contact: E-mail:huyan@fudan.edu.cn;E-mail:865768818@qq.com

摘要: 目的:总结ICU成人机械通气患者早期康复运动最佳证据,并对证据进行临床评价。方法:按金字塔“6S”模型对国内外公开发表的临床指南、系统评价、专家共识和证据总结进行检索,并根据文献质量评价要求,采用AGREE?Ⅱ和JBI?2015质量评价工具分别对纳入指南、系统评价和专家共识进行质量评价,并邀请危重症领域专家按FAME结构对总结的证据进行评价。结果:共纳入8篇文献,包括2篇指南、3篇系统评价、2篇专家共识及1篇含证据总结的临床实践,总结ICU成人机械通气患者早期康复运动最佳证据24条,包括识别康复运动需求、制定计划、运动开始时间、运动前、运动时、运动方式、运动持续时间、安全监测标准8个方面的内容,经FAME评价,所有证据通过率均在70%以上,经讨论后纳入23条证据进入临床实践。结论:本研究共总结早期康复运动最佳证据24条,根据特定临床情景纳入23条最佳证据进入临床实践,建议临床医护人员根据临床情景特异性引入适合的证据。

关键词: 重症监护病房;机械通气;早期活动,早期康复运动

Abstract: Objective: To summarize the best evidence of early rehabilitation exercise for adult patients with mechanical ventilation in ICU. Methods: The published clinical guidelines, systematic review, expert consensus and evidence summary were retrieved according to the pyramid "6S" model. A quality review was conducted with AGREE II and JBI 2015. The experts in the field of critical illness were invited to evaluate the summary evidence based on FAME principle. Results: The final review included 8 papers, including 2 guidelines, 3 systematic reviews, 2 expert consensuses, and 1 clinical practice with evidence summary. Totally 24 best evidences of early rehabilitation exercise for adult patients with mechanical ventilation in ICU were summarized, including identification of rehabilitation exercise needs, formulation of plans, start time of exercise, the interventions before and during exercise, exercise way, exercise duration and safety monitoring standards. The passing rates were more than 70% for all the evidence passed according to FAME evaluation, and 23 evidences were included in clinical practice at last. Conclusion: Totally 24 best evidences of early rehabilitation exercise were summarized, and 23 of them were recommended to clinical practice. The recommended evidence should be used according to the specificity of clinical scenarios.

Key words: ICU; mechanical ventilation; early activity; early rehabilitation exercise

中图分类号: 

  • R47