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结直肠癌患者术前预康复策略的最佳证据总结

Summary of best evidence for preoperative pre-rehabilitation strategy for patients with colorectal cancer
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摘要 目的总结结直肠癌手术患者术前预康复管理的相关证据,为临床实施术前预康复策略提供依据。方法依据“6S”金字塔证据模型,系统检索国内外中英文数据库及相关专业网站,检索时限为2012年1月1日-2022年6月30日。由2名研究者独立完成文献质量评价和资料提取,对符合质量标准的文献进行证据提取和整合。结果共纳入相关文献21篇,其中指南6篇、证据总结2篇、推荐实践1篇、临床决策3篇、系统评价4篇、专家共识3篇、随机对照试验2篇。最终形成包括术前风险评估、营养管理、贫血管理、康复训练、预防性抗血栓管理、心理干预6个方面的26条证据。结论本研究汇总结直肠癌患者术前预康复策略的证据,旨在优化结直肠癌患者术前的功能状态,减少术后并发症的发生,以促进患者术后康复。建议在证据转化时结合临床实践,且考虑每条证据的可行性和适宜性,建立结直肠癌患者术前预康复管理体系。 Objective To summarize the relevant evidence of preoperative pre-habilitation management of patients undergoing colorectal cancer surgery,so as to provide references for clinical practice.Methods According to the"6S"pyramid evidence model,the preoperative pre-habilitation management of patients undergoing colorectal cancer surgery was systematically searched in domestic and foreign databases and related professional websites,with the time setting between January 1,2012 to June 30,2022.Evidence evaluation and extraction were conducted by two independent researchers.Results Twenty-one articles were found,including 6 guidelines,2 evidence summaries,1 recommended practice,3 clinical decisions,4 systematic reviews,3 expert consensuses,and 2 randomized controlled trials.A total of 26 pieces of best evidence were integrated into six dimensions of preoperative risk assessment,nutritional management,anemia management,rehabilitation training,preventive antithrombotic therapy and psychological intervention.Conclusion This study summarized the evidence of preoperative pre-rehabilitation strategies for patients with colorectal cancer,aiming to optimize their preoperative functional status,reduce the occurrence of postoperative complications,and promote their postoperative rehabilitation.It is recommended to establish a pre-operation rehabilitation management system for such patients considering the clinical environment and the feasibility and suitability of each piece of evidence.
作者 庞晨晨 张媛 王孟妮 李梅 赵倩 冯争争 PANG Chenchen;ZHANG Yuan;WANG Mengni;LI Mei;ZHAO Qian;FENG Zhengzheng(Department of General Surgery,The Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China)
出处 《中国临床护理》 2024年第3期181-187,共7页 Chinese Clinical Nursing
基金 2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20210220)。
关键词 结直肠癌 手术 预康复 证据总结 循证护理 Colorectal cancer Operation Pre-rehabilitation Evidence summary Evidence-based nursing
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