急性心肌梗死PCI术后患者住院期运动康复的最佳证据总结

目的检索并获取急性心肌梗死PCI术后患者住院期运动康复的相关证据,并对最佳证据进行总结。方法应用循证护理的方法,使用计算机、手工相结合的形式检索国内外数据库有关急性心肌梗死PCI术后患者住院期运动康复的相关证据,包括指南、证据总结、临床实践指南、系统评价、随机对照试验等。检索时限为建库至2019年12月1日。由4组循证小组独立进行文献质量评价,有争议的内容由医院循证小组裁决,并提取证据。分别采用AGREEⅡ评分、澳大利亚JBI循证卫生保健中心文献评价标准、证据分级系统,对各类研究进行文献质量评价与等级划分。结果共纳入证据15篇,包括指南4篇、证据总结1篇、系统评价1篇、随机对照试验9篇,最终总结了20条急性心肌梗死PCI术后患者住院期运动康复的最佳证据。结论本研究归纳了关于急性心肌梗死PCI术后患者住院期运动康复的最佳证据,可以为临床开展运动康复提供循证依据,但在实际开展过程中,应结合患者文化背景与医疗机构水平,在保障患者安全的前提下循序渐进地开展。

Summary of best evidence for in-hospital exercise rehabilitation in patients with acute myocardial infarction after percutaneous coronary intervention

Objective To retrieve and obtain the relevant evidence for in-hospital exercise rehabilitation in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)and to summarize the best evidence.Methods By applying evidence-based nursing method,the relevant evidence of in-hospital exercise rehabilitation in AMI patients after PCI in domestic and foreign databases was retrieved by combining computer and manual methods,including guidelines,evidence summary,clinical practice guidelines,systematic reviews,randomized controls test and so on.The retrieval time was from the establishment of the database to December 1,2019.A total of 4 evidence-based groups independently conducted literature quality evaluation,and the controversial content was ruled by the hospital evidence-based group,and the evidence was extracted.Appraisal of guidelines research and evaluation(AGREEⅡ)and literature evaluation criteria and evidence grading system of Australia Joanna Briggs Institute(JBI)Evidence-based Health Care Center were respectively used to evaluate quality of literature and grade the various studies.Results A total of 15 articles were included,including 4 guidelines,1 evidence summary,1 systematic evaluation and 9 randomized controlled trials.Finally,20 pieces of best evidence of in-hospital exercise rehabilitation in AMI patients after PCI were summarized.Conclusions This study summarizes best evidence for in-hospital exercise rehabilitation of AMI patients after PCI,which can provide an evidence-based basis for clinical practice.However,in the actual implementation process,it should be carried out step by step on the premise of ensuring the safety of patients by combining the cultural background of patients and the level of medical institutions.