结直肠术后患者加速康复护理中实施早期活动的范围综述
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女,硕士在读,学生

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2021年度江苏省老年健康科研项目(LK2021018)


Early mobilization in enhanced recovery after surgery programs for colorectal patients:a scoping review
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    摘要:

    目的 对结直肠手术患者早期活动相关研究进行范围综述,为临床有效开展术后早期活动干预提供参考。 方法 计算机检索PubMed、Embase、CINAHL、Web of Science、Cochrane Library、Ovid、Scopus、中国知网、万方数据库及中国生物医学文献数据库发表的中英文文献,检索时限为从建库至2022年8月,对纳入文献进行汇总和分析。 结果 共纳入20篇文献,结直肠术后早期活动除传统床上和离床活动外,还包括多模式运动(如抗阻、有氧和平衡等方式相结合)、物理治疗和日常生活活动能力训练等多元化干预措施。早期活动应在评估患者安全后尽早开始,最早可在进入病房30 min后开始,活动量、频率及持续时间应根据患者具体情况动态调整;干预的安全性和可行性已得到初步证实,效果方面还需进一步探究。 结论 结直肠术后早期活动应采取多元化干预方式,术后及早开始活动是安全可行的。未来研究需结合患者的年龄、衰弱等特点构建结直肠术后早期活动的精准干预策略,同时应考虑时间、人力和成本效益,促进早期活动在术后加速康复中的有效落实。

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    Objective To identify literature on early mobilization in patients undergoing colorectal surgery, and to provide reference for clinical practice. Methods A scoping review was undertaken.The online databases including PubMed, Embase, CINAHL, Web of Science, Cochrane Library, Ovid, Scopus, CNKI, Wanfang Data, and SinoMed were searched for literature published in Chinese or English from database inception to August, 2022. Results Twenty publications met inclusion criteria.Early mobilization included not only in-bed activities and out-of-bed mobilization, but also multimodal exercise (resistance exercise, aerobic exercise and balance exercise, etc.), physiotherapy, and activities of daily living ability (ADL) training.Early mobilization should be started as early as possible if the patient is stable.It could begin at 30 minutes after the patient transferred back to the ward.Amount, frequency and duration of mobilization should be dynamically adjusted according to the patient′s condition.The safety and feasibility of early mobilization had been confirmed, but the effectiveness should be further studied. Conclusion Early mobilization may be conducted using various strategies and is safe and feasible after colorectal surgery.Future studies need to develop precise intervention strategies by considering patients′characteristics such as age and degree of frailty.Meanwhile, time, workforce, and cost-effectiveness should also be weighed to promote implementation of early mobilization in accelerated postoperative recovery program.

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王朦,陆静,尹如兰,张越,陈潇潇,施小青.结直肠术后患者加速康复护理中实施早期活动的范围综述[J].护理学杂志,2023,28(9):22-26

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  • 收稿日期:2022-12-31
  • 最后修改日期:2023-02-26
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  • 在线发布日期: 2023-12-29