经皮冠状动脉介入治疗患者心脏康复健康教育的最佳证据总结

doi:10.3761/j.issn.1672-9234.2023.02.015

摘要/Abstract

摘要： 目的整合国内外经皮冠状动脉介入治疗患者心脏康复健康教育的相关证据。方法系统检索BMJ Best Practice、UpToDate、Cochrane Library、JBI循证卫生保健数据库、中国知网、万方等数据库及指南相关专业网站中有关经皮冠状动脉介入治疗患者心脏康复健康教育的相关证据，包括临床决策、循证指南、专家共识等，并进行质量评价与证据提取。结果共纳入12篇文献，其中5篇指南、3篇临床决策、3篇专家共识和1篇证据总结。从推荐与教育、药物、运动、营养、心理、戒烟及危险因素管理7个方面总结了45条最佳证据。结论本研究总结了经皮冠状动脉介入治疗患者心脏康复健康教育的最佳证据，能够为护士进行全面、具体的健康教育提供依据。

关键词: 血管成形术, 冠心病, 放射摄影术, 介入性, 健康教育, 循证护理学

Abstract:

Objective To search and summarize the evidence of cardiac rehabilitation health education for patients after percutaneous coronary intervention. Methods We searched related evidence in BMJ Best Practice，UpToDate，Cochrane Library，JBI EBP Database，CNKI，Wanfang，and other databases and professional websites，including clinical decision-making，evidence-based guidelines，expert consensus，and quality evaluation and evidence extraction. Results A total of 12 literatures were listed，including five guidelines，three clinical decisions，three expert consensus and one evidence summary. Forty-five pieces of best evidence were summarized in seven aspects，namely recommendation and education，medication，exercise，nutrition，psychology，smoking cessation，and risk factor management. Conclusion This study summarized the best evidence of cardiac rehabilitation health education for patients after percutaneous coronary intervention，which provided nurses about how to carry out comprehensive and specific health education.

Key words: Angioplasty, Coronary Disease, Radiography, Interventional, Health Education, Evidence-Based Nursing

刘佳文, 涂惠, 李欣, 肖丹, 陈华, 徐文君, 易凤仪, 魏雯婷, 熊晓云. 经皮冠状动脉介入治疗患者心脏康复健康教育的最佳证据总结[J]. 中华护理教育, 2023, 20(2): 210-216.

LIU Jiawen, TU Hui, LI Xin, XIAO Dan, CHEN Hua, XU Wenjun, YI Fengyi, WEI Wenting, XIONG Xiaoyun. Best evidence summary of cardiac rehabilitation health education for patients after PCI[J]. Chinese Journal of Nursing Education, 2023, 20(2): 210-216.

图/表 6

图1

图2

表1

表2

表3

续表3

参考文献 27

[1]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2020概要[J]. 中国循环杂志, 2021, 36(6):521-545.
	The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases burden in China:an updated summary of 2020[J]. Chin Circ J, 2021, 36(6):521-545.
[2]	刘庆荣, 吴永健. 冠心病介入治疗术后心脏康复的综合评估[J]. 中国医刊, 2020, 55(1):1-4.
[3]	王攀. 基于移动医疗的冠心病患者健康教育方案构建研究[D]. 重庆: 重庆医科大学, 2018.
	Wang P. Construction of an m-health based health education program for patients with coronary heart disease[D]. Chongqing: Chongqing Medical University, 2018.
[4]	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017, 32(21):1991-1994.
[5]	卢舒颖, 刘宁, 魏璐华, 等. 产后出血预防及管理的最佳证据总结[J]. 护理学报, 2020(12):18-22.
[6]	AGREE Next Steps Consortium. The AGREE Ⅱ Instrument[EB/OL]. (2019-06-01)[2020-03-23].http://www.agreetrust.org/.
[7]	Newhouse RP, Dearholt SL, Poe SS, et al. Johns Hopkins nursing evidence-based practice model and guidelines[M]. Indiana-polis: Sigma Theta Tau International, 2007.
[8]	胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社, 2018:56-93.
[9]	邢唯杰, 胡雁, 周英凤, 等. 推动证据向临床转化(六)证据总结的制作与撰写[J]. 护士进修杂志, 2020, 35(12):1129-1132.
[10]	Braun LT, Gersh BJ, Parikh N, et al. Cardiac rehabilitation programs[EB/OL]. (2020-07-13).http://www.uptodate.com/.
[11]	Hennekens CH, Elmore JG, Givens J, et al. Overview of the prevention of cardiovascular disease events in those with established disease (secondary prevention) or at very high risk[EB/OL]. (2021-04-20).http://www.uptodate.com/.
[12]	Wenger NK, Gersh BJ, Parikh N, et al. Cardiac rehabilitation in older adults[EB/OL]. (2020-01-06). http://www.uptodate.com/.
[13]	Pelliccia A, Sharma S, Gati S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease[J]. Eur Heart J, 2021, 42(1):17-96. doi: 10.1093/eurheartj/ehaa605
[14]	Scottish Intercollegiate Guidelines Network. SIGN 150 cardiac rehabilitation[EB/OL]. (2017-07-01). http://www.sign.ac.uk/.
[15]	Kim C, Sung J, Lee JH, et al. Clinical practice guideline for cardiac rehabilitation in Korea:recommendations for cardiac rehabilitation and secondary prevention after acute coronary syndrome[J]. Korean Circ J, 2019, 49(11):1066-1111. doi: 10.4070/kcj.2019.0194
[16]	British Association for Cardiovascular Prevention and Rehabilitation(BACPR). The BACPR standards and core components for cardiovascular disease prevention and rehabilitation 2017[EB/OL]. [2022-02-02]. http://www.bacpr.com/resources/AC6_BACPRStandards&CoreComponents2017.pdf
[17]	中国康复医学会心血管病专业委员会. 中国心脏康复与二级预防指南[M]. 北京: 北京大学医学出版社, 2018.
[18]	Thomas RJ, Beatty AL, Beckie TM, et al. Home-based cardiac rehabilitation:a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation,the American Heart Association,and the American College of Cardiology[J]. Circulation, 2019, 140(1):e69-e89.
[19]	中华医学会心血管病学分会预防学组, 中国康复医学会心血管病专业委员会. 冠心病患者运动治疗中国专家共识[J]. 中华心血管病杂志, 2015, 43(7):575-588.
[20]	中国医师协会心血管内科医师分会预防与康复专业委员会. 经皮冠状动脉介入治疗术后运动康复专家共识[J]. 中国介入心脏病学杂志, 2016, 24(7):361-369.
[21]	陈齐, 黎蔚华, 陈煌, 等. 经皮冠状动脉介入治疗术后患者Ⅰ期心脏康复护理的最佳证据总结[J]. 解放军护理杂志, 2021, 38(1):48-52.
	Chen Q, Li WH, Chen H, et al. Best evidence summary of phase Ⅰ cardiac rehabilitation nursing for patients after percutaneous coronary intervention[J]. Nurs J Chin PLA, 2021, 38(1):48-52.
[22]	任斌, 刘达瑾, 孔永梅. 我国心脏康复发展历程及心脏运动康复研究进展[J]. 实用心脑肺血管病杂志, 2019, 27(1):1-4.
[23]	丁荣晶, 胡大一. 中国心脏康复服务发展不均衡,未来心脏康复发展潜力巨大[R/OL]. (2018-03-13)[2018-09-01].http://www.icirculation.com/article/article_detail.aspx?id=32364.
[24]	Hennekens CH, Andreotti F. Leading avoidable cause of premature deaths worldwide:case for obesity[J]. Am J Med, 2013, 126(2):97-98. doi: 10.1016/j.amjmed.2012.06.018 pmid: 23331433
[25]	GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories,1990-2016:a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2018, 392(10152):1015-1035. doi: 10.1016/S0140-6736(18)31310-2
[26]	Lichtman JH, Froelicher ES, Blumenthal JA, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome:systematic review and recommendations:a scientific statement from the American Heart Association[J]. Circulation, 2014, 129(12):1350-1369. doi: 10.1161/CIR.0000000000000019 pmid: 24566200
[27]	Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics-2019 update:a report from the American Heart Association[J]. Circulation, 2019, 139(10):e56-e528. doi: 10.1161/CIR.0000000000000659