ICU获得性衰弱相关系统评价的再评价
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摘要
目的对ICU获得性衰弱相关系统评价进行再评价,为预防ICU获得性衰弱循证护理实践方案的制定提供证据支持。方法采用系统评价再评价的方法对与ICU获得性衰弱相关的系统评价进行再评价。结果共纳入15项系统评价,内容涉及ICU获得性衰弱的危险因素、发生率、评估和诊断、预防、治疗5个方面,文献方法学质量评分4～7分;对15项系统评价的43条主要结局指标进行证据质量评价,7条证据质量等级为"高",13条为"中",18条为"低",5条为"极低"。结论系统评价再评价对ICU获得性衰弱的危险因素、发生率、评估、诊断、预防、治疗等进行证据汇总,为预防ICU获得性衰弱循证护理实践方案的建立提供了可靠的证据支持。
Objective To evaluatesy stematic reviews on ICU acquired weakness,and to provide basis for development of evidence-based nursing practice programs which aims at preventing ICU acquired weakness. Methods Overviews of current systematic reviews or Meta-analysis on ICU acquired weakness were carried out. Results Fifteen systematic reviews or meta-analysis which involved such 5 aspects of ICU acquired weakness as risk factors,incidence,assessment and diagnosis,prevention,and treatment,were included. The publications scored 4-7 points in methodological quality. Totally,43 pieces of evidence were extracted,of which,7 pieces were at high level,13 medium level,18 low level,and 5 lowest level. Conclusion The overviews of systematic reviews sums up evidence regarding risk factors,incidence,assessment and diagnosis,prevention,and treatment of ICU acquired weakness,and provides reliable evidence support for the construction of evidence-based nursing practice program aiming at preventing ICU acquired weakness.
Objective To evaluatesy stematic reviews on ICU acquired weakness,and to provide basis for development of evidence-based nursing practice programs which aims at preventing ICU acquired weakness. Methods Overviews of current systematic reviews or Meta-analysis on ICU acquired weakness were carried out. Results Fifteen systematic reviews or meta-analysis which involved such 5 aspects of ICU acquired weakness as risk factors,incidence,assessment and diagnosis,prevention,and treatment,were included. The publications scored 4-7 points in methodological quality. Totally,43 pieces of evidence were extracted,of which,7 pieces were at high level,13 medium level,18 low level,and 5 lowest level. Conclusion The overviews of systematic reviews sums up evidence regarding risk factors,incidence,assessment and diagnosis,prevention,and treatment of ICU acquired weakness,and provides reliable evidence support for the construction of evidence-based nursing practice program aiming at preventing ICU acquired weakness.
引文
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[14]Connolly B,Salisbury L,O'Neill B,et al.Exercise rehabilitation following intensive care unit discharge for recovery from critical illness[J].Cochrane Database Syst Rev,2015(6):CD008632.
[15]Mehrholz J,Pohl M,Kugler J,et al.Physical rehabilitation for critical illness myopathy and neuropathy[J].Cochrane Database Syst Rev,2015(3):CD010942.
[16]Sosnowski K,Lin F,Mitchell M L,et al.Early rehabilitation in the intensive care unit:an integrative literature review[J].Aust Crit Care,2015,28(4):216-225.
[17]Vanpee G,Hermans G,Segers J,et al.Assessment of limb muscle strength in critically ill patients:a systema-tic review[J].Crit Care Med,2014,42(3):701-711.
[18]Witteveen E,Wieske L,Verhamme C,et al.Muscle and nerve inflammation in intensive care unit-acquired weakness:a systematic translational review[J].J Neurol Sci,2014,345(1-2):15-25.
[19]Hermans G,De Jonghe B,Bruyninckx F,et.al.Interventions for preventing critical illness polyneuropathy and critical illness myopathy[J].Cochrane Database Syst Rev,2014(1):CD006832.
[20]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.
[21]Calvo-Ayala E,Khan B A,Farber M O,et al.Interventions to improve the physical function of ICU survivors:a systematic review[J].Chest,2013,144(5):1469-1480.
[22]Stevens R D,Dowdy D W,Michaels R K,et al.Neuromuscular dysfunction acquired in critical illness:a systematic review[J].Intensive Care Med,2007,33(11):1876-1891.
[23]赵贵美,焦琳琳,杨桂华.早期循序渐进运动对ICU患者获得性衰弱影响的Meta分析[J].中华护理杂志,2017,52(2):177-181.
[24]刘雅莉,袁金秋,杨克虎,等.系统评价再评价的制作方法简介及相关资料分析[J].中国循证儿科杂志,2011,6(1):58-64.
[2]Witteveen E,Wieske L,Verhamme C,et al.Muscle and nerve inflammation in intensive care unit-acquired weakness:a systematic translational review[J].J Neurol Sci,2014,345(1-2):15-25.
[3]Lipshutz A K,Gropper M A.Intensive Care Unit acquired muscle weakness:an ounce of prevention is worth a pound of cure[J].Anesthesiology,2016,124(1):7-9.
[4]周茜,耿亚琴,狄捷,等.器械拉力操预防ICU获得性衰弱效果研究[J].护理学杂志,2016,31(17):18-20.
[5]Higgins J P,Green S.Cochrane Handbook for Syste-matic Reviews of Interventions[R].London:The Cochrane Collaboration,2011.
[6]Oxman A D,Guyatt G H,Singer J,et al.Agreement among reviewers of review articles[J.J Clin Epidemiol,1991,44(1):91-98.
[7]曾宪涛,冷卫东,李胜,等.如何正确理解及使用GRADE系统[J].中国循证医学杂志,2011,11(9):985-990.
[8]张树光,严杰,陈璇,等.健身气功干预糖尿病有效性及安全性的系统评价再评价[J].护理学杂志,2017,32(19):96-99.
[9]Price D R,Mikkelsen M E,Umscheid C A,et al.Neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness:a systematic review and meta-analysis[J].Crit Care Med,2016,44(11):2070-2078.
[10]Shepherd S J,Newman R,Brett S J,et al.Pharmacological therapy for the prevention and treatment of weakness after critical illness:a systematic review[J].Crit Care Med,2016,44(6):1198-1205.
[11]Castro-Avila A C,Seron P,Fan E,et al.Effect of early rehabilitation during intensive care unit stay on functio-nal status:systematic review and meta-analysis[J].PLo S One,2015,10(7):e130722.
[12]Bunnell A,Ney J,Gellhorn A,et al.Quantitative neuromuscular ultrasound in intensive care unit-acquired weakness:a systematic review[J].Muscle Nerve,2015,52(5):701-708.
[13]Appleton R T,Kinsella J,Quasim T.The incidence of intensive care unit-acquired weakness syndromes:a systematic review[J].J Intensive Care Soc,2015,16(2):126-136.
[14]Connolly B,Salisbury L,O'Neill B,et al.Exercise rehabilitation following intensive care unit discharge for recovery from critical illness[J].Cochrane Database Syst Rev,2015(6):CD008632.
[15]Mehrholz J,Pohl M,Kugler J,et al.Physical rehabilitation for critical illness myopathy and neuropathy[J].Cochrane Database Syst Rev,2015(3):CD010942.
[16]Sosnowski K,Lin F,Mitchell M L,et al.Early rehabilitation in the intensive care unit:an integrative literature review[J].Aust Crit Care,2015,28(4):216-225.
[17]Vanpee G,Hermans G,Segers J,et al.Assessment of limb muscle strength in critically ill patients:a systema-tic review[J].Crit Care Med,2014,42(3):701-711.
[18]Witteveen E,Wieske L,Verhamme C,et al.Muscle and nerve inflammation in intensive care unit-acquired weakness:a systematic translational review[J].J Neurol Sci,2014,345(1-2):15-25.
[19]Hermans G,De Jonghe B,Bruyninckx F,et.al.Interventions for preventing critical illness polyneuropathy and critical illness myopathy[J].Cochrane Database Syst Rev,2014(1):CD006832.
[20]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.
[21]Calvo-Ayala E,Khan B A,Farber M O,et al.Interventions to improve the physical function of ICU survivors:a systematic review[J].Chest,2013,144(5):1469-1480.
[22]Stevens R D,Dowdy D W,Michaels R K,et al.Neuromuscular dysfunction acquired in critical illness:a systematic review[J].Intensive Care Med,2007,33(11):1876-1891.
[23]赵贵美,焦琳琳,杨桂华.早期循序渐进运动对ICU患者获得性衰弱影响的Meta分析[J].中华护理杂志,2017,52(2):177-181.
[24]刘雅莉,袁金秋,杨克虎,等.系统评价再评价的制作方法简介及相关资料分析[J].中国循证儿科杂志,2011,6(1):58-64.