肺移植术后患者出院随访的证据总结

doi:10.3761/j.issn.1672-9234.2024.11.019

摘要/Abstract

摘要：

目的总结肺移植术后出院随访的最佳证据，为医护人员开展肺移植术后患者的随访提供参考。方法检索BMJ Best Practice、UpToDate、JBI、国内外相关指南网站、中英文数据库及国际心肺移植协会网站中与肺移植术后出院随访的相关证据。由2名研究人员独立进行文献筛选和质量评价。结果共纳入12篇文献，包括系统评价、指南各1篇，专家共识6篇，临床决策和证据总结各2篇。涉及随访人员、随访方式、随访频率、随访内容、随访记录和健康教育6个方面，共16条证据。结论总结的肺移植术后患者出院随访证据以专家共识为主，医护人员在应用证据的同时可结合患者肺移植类型、基础疾病及移植后的时间和进展对患者实施科学的随访管理，以减少患者肺移植术后并发症的发生、延长其术后生存期限。

关键词: 循证护理学, 肺移植, 随访, 证据总结

Abstract:

Objective To summarize the best evidence for discharge follow-up of patients after lung transplantation，so as to provide references for medical staffs. Methods The relevant evidence related to discharge follow-up after lung transplantation was retrieved from BMJ Best Practice，UpToDate，JBI，guideline networks，Chinese and English databases，and the website of International Heart Lung Transplantation Association. Literature screening and quality evaluation were conducted independently by two researchers. Results A total of 12 pieces of literature were included，including one systematic review，one guideline，six expert consensus，two clinical decisions and two evidence summaries. The evidence covered six aspects： follow-up personnel，methods，frequency，content，documen-tation，and health education，resulting in a total of 16 pieces of evidence. Conclusion This study summarized the best evidence of discharge follow-up for patients after lung transplantation. Medical staffs can implement scientific follow-up management according to patients’ lung transplantation type，underlying disease，time and progress after transplantation while applying evidences，so as to reduce the occurrence of complications after lung transplantation and prolong the postoperative survival time.

Key words: Evidence-Based Nursing, Lung transplantation, Follow-up, Evidence summary

周海清, 孙亚茹, 褚秀美, 谷如婷, 李晓莉, 盖玉彪, 马若云, 王其琛, 王秀秀, 魏丽丽. 肺移植术后患者出院随访的证据总结[J]. 中华护理教育, 2024, 21(11): 1390-1396.

Haiqing ZHOU, Yaru SUN, Xiumei CHU, Ruting GU, Xiaoli LI, Yubiao GAI, Ruoyun MA, Qichen WANG, Xiuxiu WANG, Lili WEI. Best evidence summary for discharge follow-up of patients after lung transplantation[J]. Chinese Journal of Nursing Education, 2024, 21(11): 1390-1396.

图/表 3

参考文献 38

[1]	Lee KH, Jeong SJ, Kim SY, et al. Effects of multidrug-resistant bacteria in donor lower respiratory tract on early posttran-splant pneumonia in lung transplant recipients without pretran-splant infection[J]. Transplantation, 2020, 104(4):e98-e106.
[2]	Yusen RD, Edwards LB, Kucheryavaya AY, et al. The registry of the International Society for Heart and Lung Transplantation:thirty-second official adult lung and heart-lung transplantation report:2015;focus theme:early graft failure[J]. J Heart Lung Transplant, 2015, 34(10):1264-1277.
[3]	Dégot T, Douvry B, Falque L, et al. Follow-up strategies for lung transplant recipients in France[J]. Rev Mal Respir, 2023, 40(4):314-323. doi: 10.1016/j.rmr.2023.01.024 pmid: 36868975
[4]	Zembala M, Religa Z, Large S, et al. An 18-year follow-up after the first successful heart-lung transplant in Poland. Authors’ tribute to the pioneers of heart and lung transplantation[J]. Kardiol Pol, 2020, 78(7/8):773-775.
[5]	Di Nardo M, Tikkanen J, Husain S, et al. Postoperative manage-ment of lung transplant recipients in the intensive care unit[J]. Anesthesiology, 2022, 136(3):482-499.
[6]	朱雪芬, 张英, 吴婷. 基于微信平台的自我管理应用于肺移植术后患者居家康复的影响[J]. 实用临床护理学电子杂志, 2019, 4(37):170-181.
[7]	Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ:advancing guideline development,reporting and evaluation in health care[J]. J Clin Epidemiol, 2010, 63(12):1308-1311. doi: 10.1016/j.jclinepi.2010.07.001 pmid: 20656455
[8]	周英凤, 胡雁, 朱政, 等. JBI循证卫生保健模式的更新及发展[J]. 护理学杂志, 2017, 32(3):81-83.
[9]	胡雁. 循证护理学[M]. 北京: 人民卫生出版社, 2018.
[10]	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.
[11]	Hu L, Lingler JH, Sereika SM, et al. Nonadherence to the me-dical regimen after lung transplantation:a systematic review[J]. Heart Lung, 2017, 46(3):178-186. doi: S0147-9563(17)30018-3 pmid: 28187909
[12]	Hirche TO, Knoop C, Hebestreit H, et al. Practical guidelines:lung transplantation in patients with cystic fibrosis[J]. Pulm Med, 2014,2014:621342.
[13]	Afshar K. Future direction of immunosuppression in lung transplantation[J]. Curr Opin Organ Transplant, 2014,19:583-590.
[14]	陈瑞云, 杨慧, 卢颖, 等. 肺移植患者运动训练的证据总结[J]. 中国护理管理, 2021, 21(5):734-739.
	Chen RY, Yang H, Lu Y, et al. Summary of the evidence for exercise training for lung transplant patients[J]. Chin Nurs Manag, 2021, 21(5):734-739.
[15]	洪丽微, 侯春怡, 沈香香, 等. 肺移植术后出院患者并发症预防与管理的最佳证据总结[J]. 护理学报, 2022, 29(18):47-52.
	Hong LW, Hou CY, Shen XX, et al. Best evidence summary for prevention and management of complication in discharged patients after lung transplantation[J]. J Nurs China, 2022, 29(18):47-52.
[16]	卫栋, 范立, 班乐. 中国肺移植术后并发症诊疗和随访技术规范(2019版)[J]. 中华移植杂志(电子版), 2019, 13(2):99-108.
	Wei D, Fan L, Ban L. Technical specification for diagnosis and treatment of complications and postoperative follow-up after lung transplantation in China(2019 edition)[J]. Chin J Transplant Electron Ed, 2019, 13(2):99-108.
[17]	周海琴, 朱雪芬, 黄琴红. 肺移植护理技术操作规范[J]. 实用器官移植电子杂志, 2019, 7(5):340-342.
[18]	Laporta Hernández R, Lázaro Carrasco MT, Varela de Ugarte A, et al. Long-term follow-up of the lung transplant patient[J]. Arch Bronconeumol, 2014, 50(2):67-72.
[19]	Shah P, Lowery E, Chaparro C, et al. Cystic fibrosis foundation consensus statements for the care of cystic fibrosis lung transplant recipients[J]. J Heart Lung Transplant, 2021, 40(7):539-556.
[20]	Crespo MM, Claridge T, Domsic RT, et al. ISHLT consensus document on lung transplantation in patients with connective tissue disease:part Ⅲ:pharmacology,medical and surgical management of post-transplant extrapulmonary conditions statements[J]. J Heart Lung Transplant, 2021, 40(11):1279-1300.
[21]	曾妃, 兰美娟, 梁江淑渊, 等. 肺移植患者术后肺康复护理专家共识[J]. 中华护理杂志, 2024, 59(1):10-15.
	Zeng F, Lan MJ, Liang JSY, et al. Expert consensus on posto-perative pulmonary rehabilitation nursing for lung transplant patients[J]. Chin J Nurs, 2024, 59(1):10-15.
[22]	潘红, 蔡英华, 许正红, 等. 营养支持联合早期运动对肺移植术后患者康复的影响[J]. 护理学杂志, 2019, 34(9):42-44.
[23]	孙燕燕, 吴婷, 柯宇静, 等. 肺移植受者心理体验质性研究的Meta整合[J]. 中华护理杂志, 2022, 57(6):673-679. doi: 10.3761/j.issn.0254-1769.2022.06.005
	Sun YY, Wu T, Ke YJ, et al. Psychological experience of lung transplant recipients:a qualitative meta-synthesis[J]. Chin J Nurs, 2022, 57(6):673-679. doi: 10.3761/j.issn.0254-1769.2022.06.005
[24]	Small B, Au J, Brink H, et al. Induction and maintenance immunosuppression in lung transplantation[J]. Indian J Thorac Cardiovasc Surg, 2021,38:300-317.
[25]	许茗, 杨小琴, 鲁敏. 以人文关怀为依托的延续护理在肺移植患者术后自我护理中的效果[J]. 中国胸心血管外科临床杂志, 2023, 30(4):593-596.
[26]	钱婷, 李小杉, 王文静, 等. 肺移植术后肺部细菌感染的危险因素及其对死亡风险的影响分析[J]. 东南大学学报(医学版), 2023, 42(3):348-356.
[27]	胡树菁, 孙菁, 彭复聪, 等. 肺移植受者居家护理需求质性研究的Meta整合[J]. 中华护理杂志, 2021, 56(10):1576-1583. doi: 10.3761/j.issn.0254-1769.2021.10.022
[28]	Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement:key concepts and advances in pulmonary rehabilitation[J]. Am J Respir Crit Care Med, 2013, 188(8):e13-e64.
[29]	Dew MA, Dimartini AF, De Vito Dabbs A, et al. Adherence to the medical regimen during the first two years after lung transplantation[J]. Transplantation, 2008, 85(2):193-202. doi: 10.1097/TP.0b013e318160135f pmid: 18212623
[30]	陈文倩, 张雷, 张弋, 等. 实体器官移植他克莫司个体化治疗专家共识[J]. 实用器官移植电子杂志, 2022, 10(4):301-308.
[31]	魏瑞丽, 李旭静, 任曼曼, 等. 连续性护理模式对脑卒中患者家庭照顾者生存质量的影响[J]. 中国实用神经疾病杂志, 2016, 19(1):27-30.
[32]	马涛. 延续性护理对肾移植术后出院患者自我管理及生活质量影响[J]. 中国药物与临床, 2020, 20(15):2651-2652.
[33]	Rosenberger EM, DeVito Dabbs AJ, DiMartini AF, et al. Long-term follow-up of a randomized controlled trial evaluating a mobile health intervention for self-management in lung transplant recipients[J]. Am J Transplant, 2017, 17(5):1286-1293. doi: 10.1111/ajt.14062 pmid: 27664940
[34]	Chambers DC, Cherikh WS, Goldfarb SB, et al. The internatio-nal thoracic organ transplant registry of the International Society for Heart and Lung Transplantation:thirty-fifth adult lung and heart-lung transplant report-2018;focus theme:multiorgan transplantation[J]. J Heart Lung Transplant, 2018, 37(10):1169-1183.
[35]	郑晓敏, 蔡英华, 周海琴, 等. 快速康复外科理念在肺移植患者围手术期中应用的范围综述[J]. 中华护理杂志, 2022, 57(16):2018-2024.
[36]	Schenkel FA, Barr ML, McCloskey CC, et al. Use of a blue-tooth tablet-based technology to improve outcomes in lung transplantation:a pilot study[J]. Am J Transplant, 2020, 20(12):3649-3657.
[37]	程梦园. 基于移动健康的肺移植受者生活质量干预方案的构建研究[D]. 芜湖: 皖南医学院, 2022.
[38]	吕秀霞, 陈瑞云, 魏立, 等. 肺移植患者肺康复的研究进展[J]. 中华护理杂志, 2019, 54(5):765-770. doi: 10.3761/j.issn.0254-1769.2019.05.029