以质量求发展,以服务铸品牌

护理学报 ›› 2023, Vol. 30 ›› Issue (2): 48-53.doi: 10.16460/j.issn1008-9969.2023.02.048

• 循证护理 • 上一篇    下一篇

神经重症患儿早期活动的最佳证据总结

李朴1a, 王梅1a, 宇丽1b, 刘敏1a, 李平2, 张泓1c, 陈瑜3, 胡雁3, 胡少华1d   

  1. 1.安徽医科大学第一附属医院,a.急诊外科;b.PICU;c.急诊内科;d.护理部,安徽 合肥 230022;
    2.北京空军特色医学中心 门诊部,北京 100142;
    3.复旦大学 护理学院 复旦大学 Joanna Briggs 循证护理中心,上海 200032
  • 收稿日期:2022-09-08 出版日期:2023-01-25 发布日期:2023-02-22
  • 通讯作者: 胡少华(1971-),女,安徽合肥人,博士,副教授,主任护师,护理部主任。E-mail:hushaohua1003@126.com
  • 作者简介:李朴(1988-),女,安徽合肥人,硕士,主管护师。
  • 基金资助:
    2019年安徽省临床重点专科(急危重症护理专科)建设项目; 2020年度安徽省卫生健康科学研究项目(2020WR02003); 复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202140)

Best evidence summary for early mobilization in children with severe neurological impairment

LI Pu1a, WANG Mei1a, YU Li1b, LIU Min1a, LI Ping2, ZHANG Hong1c,CHEN Yu3, HU Yan3, HU Shao-hua1d   

  1. 1a. Dept. of Emergency Surgery; 1b. PICU; 1c. Dept. of Emergency Medicine; 1d. Dept. of Nursing Administration, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China;
    2. Outpatient Department, Air Force Specialty Medical Center, Beijing 100142, China;
    3. School of Nursing, Joanna Briggs Evidence-based Nursing Center, Fudan University, Shanghai 200032, China
  • Received:2022-09-08 Online:2023-01-25 Published:2023-02-22

摘要: 目的 对国内外的神经重症患儿早期活动的最佳证据进行总结,为临床实践提供参考资料。方法 遵循循证护理方法确定循证问题,检索国内外关于神经重症患儿早期活动的相关文献并进行质量评价提取证据。结果 最终纳入文献15篇,提取内容包括组织环境、早期评估、绝对禁忌证、相对禁忌证、不耐受监测、活动内容、安全核查和应急预案及人员培训8个维度共30条证据。结论 本研究总结了目前关于神经重症儿童早期活动的最佳证据,有利于规范护理人员循证评估和管理神经重症儿童早期活动的情况,改善患儿预后,提高护理质量。

关键词: 神经重症, 儿童, 早期活动, 最佳证据, 循证护理

Abstract: Objective To summarize the best evidence of early mobilization in children with severe neurological impairment (SNI) at home and abroad and to provide reference for clinical practice. Methods Evidence-based problems were determined according to evidence-based nursing method. Domestic and foreign literature on early mobilization of children with SNI were searched and the quality evaluation was carried out to extract the evidence. Results Fifteen articles were included, and 30 pieces of evidence were extracted from 8 dimensions, including organizational environment, early assessment, absolute contraindications, relative contraindications, intolerance monitoring, activity content, safety verification and emergency plan, and personnel training. Conclusion The present study summarizes the best evidence on early mobilization of children with SNI, which is beneficial to standardizing the evidence-based evaluation and management of early mobilization of children with SNI, and improving the prognosis and the quality of nursing.

Key words: severe neurological impairment, children, early mobilization, best evidence, evidence-based nursing

中图分类号: 

  • R473.72
[1] 崔焱,仰曙芬.儿科护理学[M].北京:人民卫生出版社,2017:5-6.
[2] 陈玉霞,肖农.儿童神经重症的早期康复策略[J].中国小儿急救医学,2020, 27(6):421-425.DOI:10.3760/cma.j.issn.1673-4912.2020.06.005.
[3] 中华医学会儿科学分会康复学组.重视儿童重症康复与评定[J].中国实用儿科杂志, 2018, 33(8):566-569.DOI:10.19538/j.ek2018080602.
[4] Cuello-Garcia CA, Mai SHC, Simpson R, et al.Early mobilization in critically ill children: a systematic review[J]. J Pediatr, 2018,203:25-33. DOI:10.1016/j.jpeds.2018.07.037.
[5] Biagas KV, Hough RF.Post-intensive care syndrome: a look at PICU outcomes[J]. Pediatr Crit Care Med, 2016,17(11):1101. DOI:10.1097/PCC.0000000000000975.
[6] Greenham M, Knight S, RoddaPhD J, et al. Australian clinical consensus guideline for the subacute rehabilitation of childhood stroke[J]. Int J Stroke,2021,16(3):311-320. DOI:10.1177/1747493020941279.
[7] Choong K, Foster G, Fraser DD, et al.Acute rehabilitation practices in critically ill children: a multicenter study[J].Pediatr Crit Care Med, 2014,15(6):e270-e279. DOI:10.1097/PCC.0000000000000160.
[8] Kayambu G,Boots R, Paratz J.Physical therapy for the critically ill in the ICU: a systematic review and meta-analysis[J]. Crit Care Med,2013, 41(6):1543-1554. DOI:10.1097/CCM.0b013e31827ca637.
[9] AVERT Trial Collaboration Group.Efficacy and safety of very early mobilisation within 24h of stroke onset (AVERT): a randomised controlled trial[J].Lancet, 2015,386(9988):46-55. DOI:10.1016/S0140-6736(15)60690-0.
[10] Ista E, Scholefield BR, Manning JC, et al.Mobilization practices in critically ill children: a european point prevalence study (EU PARK-PICU)[J]. Crit Care,2020,24(1):368. DOI:10.1186/s13054-020-02988-2.
[11] Franz S, Muser J, Thielhorn U,et al.Inter-professional communication and interaction in the neurological rehabilitation team: a literature review[J]. Disabil Rehabil,2020,42(11):1607-1615. DOI:10.1080/09638288.2018.1528634.
[12] 王素娟. 儿童危重症早期康复的现状[J].中国小儿急救医学,2020,27(6):415-420.DOI:10.3760/cma.j.issn.1673-4912.2020.06.004.
[13] Choong K, Awladthani S, Khawaji A, et al.Early exercise in critically ill youth and children, a preliminary evaluation: the wEECYCLE Pilot Trial[J]. Pediatr Crit Care Med,2017,18(11):e546-e554.DOI:10.1097/PCC.0000000000001329.
[14] 胡雁,周英凤,朱政,等.通过循证护理实践促进护理知识转化[J].护士进修杂志, 2015, 30(11):961-963. DOI:10.16821/j.cnki.hsjx.2015.11.001.
[15] 周英凤,胡雁,顾莺,等.促进基于证据的最佳实践持续改进临床质量[J].护理研究,2016,30(35):4432-4434. DOI:10.3969/j.issn,1009-6493.2016.35.025.
[16] Cheng L, Broome ME, Feng S,et al.A grounded theory on evidence-based nursing implementation in China[J]. Int Nurs Rev, 2018,65(2):270-278. DOI:10.1111/inr.12396.
[17] 朱政,胡雁,周英凤,等.推动证据向临床转化(五)证据临床转化研究中的文献质量评价[J].护士进修杂志,2020,35(11):996-1000. DOI:10.16821/j.cnki.hsjx.2020.11.009.
[18] AGREE Project Office. The AGREE II instrument[EB/OL].(2009-05-01)[2021-12-08].http://www.agreetrust.org.
[19] 胡雁,郝玉芳.循证护理学[M].北京:人民卫生出版社,2020:80-93.
[20] The Joanna Briggs Institute.Critical appraisal tools[EB/OL].(2017-11-24)[2021-12-08].http://joannabriggs.org/research/critical-appraisal-tool.
[21] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015, 30(11):964-967. DOI:10.16821/j.cnki.hsjx.2015.11.002.
[22] RCPCH. Stroke in childhood: clinical guideline for diagnosis, management and rehabilitation[EB/OL]. (2014-03-01)[2017-06-01].https://www.nice.org.uk//guidance/stroke-in-childhood.
[23] Green M, Marzano V, Leditschke IA, et al.Mobilization of intensive care patients: a multidisciplinary practical guide for clinicians[J]. J Multidiscip Healthc, 2016,9:247-256. DOI:10.2147/JMDH.S99811.
[24] Hebert D, Lindsay MP, McIntyre A, et al. Canadian stroke best practice recommendations: stroke rehabilitation practice guidelines, update 2015[J]. Int J Stroke, 2016,11(4):459-484. DOI:10.1177/1747493016643553.
[25] 国家卫生计生委脑卒中防治工程委员会,脑卒中防治系列指导规范编审委员会.中国脑卒中护理指导规范[EB/OL].(2017-07-20).http://sinosc.chinasdc.cn/NewsInfo/News/NewsDetailWeb?Tid=2064.
[26] Mirkowski M, McIntyre A, Faltynek P, et al. Nonpharmacological rehabilitation interventions for motor and cognitive outcomes following pediatric stroke: a systematic review[J]. Eur J Pediatr,2019,178(4):433-454. DOI:10.1007/s00431-019-03350-7.
[27] 中华医学会儿科学分会康复学组,中国康复医学会物理治疗专委会.中国神经重症儿童的亚重症康复管理专家共识(2021)[J].中华危重病急救医学,2021,33(10):1165-1174. DOI:10.3760/cma.j.cn121430-20210810-01160.
[28] 倪莹莹,王首红,宋为群,等.神经重症康复中国专家共识(上)[J].中国康复医学杂志,2018,33(1):7-14. DOI:10.3969/jissn.1001-1242.2018.01.003.
[29] Choong K, Canci F, Clark H, et al.Practice recommendations for early mobilization in critically ill children[J]. J Pediatr Intensive Care, 2018,7(1):14-26. DOI:10.1055/s-0037-1601424.
[30] 王秋雁,边仁秀,戎军,等.浙江省重症康复专家共识[J].浙江医学,2017, 39(24):2191-2196.DOI:10.12056/jissn1006-2785201739.24.2017-2801.
[31] 谢鸿翔,肖农,李海峰,等.中国儿童康复质控管理专家共识[J].中国实用儿科杂志,2020,35(6):435-438.DOI:10.19538/j.ek2020060604.
[32] 宋鲁平,孙炜,吴毅,等.中国重型颅脑创伤早期康复管理专家共识(2017)[J].中华医学杂志,2017,97(21):1615-1623. DOI:10.3760/cma.i.issn.0376-2491.2017.21.006.
[33] 杜晓亮,胡娜,王倩云,等.神经外科家庭参与式交班模式的实践[J].护理学报,2021,28(2):16-19.DOI:10.16460/j.issn1008-9969.2021.02.016.
[1] 张静, 彭焕椽, 陈佳, 鲁永锦, 刘克玄, 侯晓敏. 成人体外循环心脏手术患者预防手术部位感染的最佳证据总结[J]. 护理学报, 2025, 32(4): 41-47.
[2] 李若雨, 刘鑫, 林萍, 陈丹, 林桦. 出院患者用药安全管理的最佳证据总结[J]. 护理学报, 2025, 32(3): 50-55.
[3] 杨小娟, 毛孝容, 王静, 江华, 李蓉, 樊宇, 文青, 李林章, 陈晓容. 成人重度烧伤患者早期肠内营养管理的最佳证据总结[J]. 护理学报, 2025, 32(3): 56-61.
[4] 魏利, 赵兴颖, 刘佳, 何雨璇, 陈晓梅, 杨雪, 鲜继淑, 杨燕妮. 神经外科重症住院患者家庭照顾者照顾负担及影响因素分析[J]. 护理学报, 2025, 32(2): 1-6.
[5] 刘硕怡, 熊莉娟, 李凌, 王玉梅, 何嘉, 李鑫, 袁淑蕾, 郭雪琴, 王暘婧, 张慧娟. 老年住院患者衰弱预防及管理临床实践指南的质量评价及内容分析[J]. 护理学报, 2025, 32(2): 50-55.
[6] 闫亚铃, 乐美妮, 姚桃琴, 王雪莲, 姜建玲, 辛艺. 老年胃肠肿瘤患者围手术期衰弱管理方案的构建[J]. 护理学报, 2025, 32(2): 74-78.
[7] 毕雅昕, 端烨, 何丽君, 徐秒, 龚荣花. 减重代谢术后骨质疏松症预防与管理的最佳证据总结[J]. 护理学报, 2025, 32(1): 44-49.
[8] 陈莹莹, 丁红, 张根生. 患儿术后谵妄影响因素的研究进展[J]. 护理学报, 2024, 31(9): 32-35.
[9] 陈洁, 孟庆童, 刘惊今, 吴艳妮. 基于指南的慢性心力衰竭患者运动康复科普手册研制[J]. 护理学报, 2024, 31(9): 36-41.
[10] 符路路, 解艺璇, 王玥, 魏巍, 张传英, 朱宇. 新生儿操作性疼痛听觉刺激干预的证据总结[J]. 护理学报, 2024, 31(9): 42-47.
[11] 纪锐婷, 林丹娜, 刘小成, 李婷婷, 谢映梅, 胡冰, 应文娟. 早产儿初乳口腔免疫疗法的最佳证据总结[J]. 护理学报, 2024, 31(8): 37-42.
[12] 张小莉, 杨鑫玉, 肖宇, 刘春燕, 张璐, 伍晓琴, 黄月霖, 傅静. 晚期癌症患者代理决策者安宁疗护决策后悔研究的范围综述[J]. 护理学报, 2024, 31(8): 49-54.
[13] 周毅峰, 杨继平, 胡正中, 袁浩. 肝癌切除手术患者目标导向性血糖监测的证据总结[J]. 护理学报, 2024, 31(7): 46-50.
[14] 莫选菊, 吴远, 张曼, 刘章来, 申铁梅. 共患慢性失眠症住院患者实施睡眠限制疗法的证据总结[J]. 护理学报, 2024, 31(6): 62-66.
[15] 张可, 欧阳丽, 吴成慧, 廖秋燕, 谭玲玲, 朱维晔. 特定型语言障碍儿童语言发育水平的影响因素及路径分析[J]. 护理学报, 2024, 31(4): 7-11.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!