摘要
背景与目的 肺移植受者(lung transplant recipients, LTRs)术后的康复管理是影响肺功能恢复的重要环节,本研究系统总结、归纳LTRs术后肺功能康复管理的相关证据,为临床制定LTRs术后肺功能康复管理策略提供依据。方法 根据a6So证据模型,系统检索建库至2025年7月,包括Up To Date、BMJ Best Practice、Cochrane Library、Web of Science、中国生物医学文献数据库、中国知网、万方数据库、国际指南协作网、中国医脉通指南网等在内的国内外数据库及网站,提取肺移植术后肺功能康复管理的相关证据,并由2名研究者对文献进行质量评价、证据提取及整合。结果 共纳入文献18篇,其中专家共识3篇、系统评价/证据总结4篇、随机对照试验4篇、类实验研究5篇、队列研究2篇。汇总最佳证据30条,包括康复评估、早期干预、运动训练、营养管理、药物管理、呼吸功能训练、心理支持及长期随访等8个主题。结论 本研究基于循证原则总结LTRs术后肺功能康复训练的最佳证据,提出30条临床应用型建议,为临床实施肺功能康复管理实践提供理论依据。临床医护应结合具体情境及专业判断,对证据进行实践转化,为LTRs提供科学的康复管理及指导。
Background and objective For lung transplant recipients(LTRs),rehabilitation management after lung transplantation is a crucial link affecting the recovery of pulmonary function.This study systematically summarizes and generalizes the relevant evidences on postoperative pulmonary function rehabilitation management in LTRs,thereby providing a basis for formulating clinical strategies for postoperative pulmonary function rehabilitation management in this patient population.Methods Based on the"6S"evidence model,a systematic search was conducted in domestic and international databases and websites,including UpToDate,BMJ Best Practice,Cochrane Library,Web of Science,China Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),Wanfang Database,Guidelines International Network(GIN),and China Yimai Tong Guidelines Network,from the establishment of each database to July 2025.Relevant evidences on postoperative pulmonary function rehabilitation management for LTRs were extracted,and two researchers independently conducted quality assessment,evidence extraction,and integration of the included literature.Results A total of 18 studies were included,consisting of 3 expert consensuses,4 systematic reviews/evidence summaries,4 randomized controlled trials(RCTs),5 quasi-experimental studies,and 2 cohort studies.A total of 30 pieces of best evidence were summarized,covering 8 themes:rehabilitation assessment,early intervention,exercise training,nutritional management,medication management,respiratory function training,psychological support,and long-term follow-up.Conclusion Based on evidence-based principles,this study summarizes the best evidence for postoperative pulmonary function rehabilitation training in LTRs and proposes 30 clinically applicable recommendations,which provides a theoretical basis for the clinical implementation of pulmonary function rehabilitation management.Clinical medical and nursing staff should combine specific clinical scenarios and professional judgments to translate the evidence into practice,and provide scientific rehabilitation management and guidance for LTRs.
作者
应金宏
王莺
钱佳
Jinhong YING;Ying WANG;Jia QIAN(Operating Room,The First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310024,China)
出处
《中国肺癌杂志》
北大核心
2025年第9期680-688,共9页
Chinese Journal of Lung Cancer
关键词
肺移植
肺康复
肺功能训练
康复管理
证据总结
循证医学
Lung transplantation
Pulmonary rehabilitation
Pulmonary function training
Rehabilitation management
Evidence synthesis
Evidence-based medicine
