中华护理杂志2023年3月第58卷第6期证据综合研究膝骨关节炎患者自我管理的最佳证据总结单雪琪余姜璇王俊杰许娅文沈睿王高蒿【摘要】目的提取、评价和整合膝骨关节类患者自我管理相关证据,以期为提高藤骨关节类患者自我管理质量提供循证依据。方法计算机检索指南网站、专业学会网站及综合数据库中关于藤骨关节类患者自我管理的相关文献,文献类型包括临床决策、指南、专家共识、推荐实践、证据总结、系统评价、Mta分析、随机对照试验,检索时限为2012年1月一2022年10月。结果共纳入25篇文献,包括11篇指南、4篇专家共识、1篇临床决策、4篇系统评价、5篇随机对照试验。共提取出证据30条,经过整理与讨论,将证据整合为学习相关知识、运动管理、体重管理、关节保护4个类别。结论该研完总结的膝骨关节类惑者自我管理最佳证据质量高、权威性强,可为临床医护人贡提供循证依据,以便更科学、有效地蒂助藤骨关节炎惑者进行自我管理。【关键词】骨关节类,藤;自我管理;循证护理学Evidence summary of self-management for patients with knee osteoarthritis/SHAN Xueqi,YU Jiangxuan,WANG Junjie,XU Yawen,SHEN Rui,WANG Xixi[Abstract]Objective To extract,summarize and evaluate the best evidence of self-management for patients withknee osteoarthritis(KOA),and to provide evidence-based evidence for improving self-management of patients withKOA.Methods We searched the guidelines websites,association official websites and integrated databases,for allliterature on self-management of patients with KOA;the types of literature included clinical decision-making,guidelines,evidence summaries,expert-consensuses,systematic reviews and randomized controlled trials.The retrievaltime was from January 2012 to October 2022.Results A total of 25 articles were included,including 11guidelines,4 expert consensuses,I clinical decision,4 systematic reviews and 5 randomized controlled trials.A totalof 30 pieces of evidence were extracted.After sorting and discussion,the evidence was integrated into 4 areas,namely learning KOA related knowledge,exercise management,weight management and joint protection.ConclusionThe evidence of self-management of patients with KOA is abundant,high quality and authoritative,which canprovide evidence-based bases for clinical medical staff,so as to help patients with KOA carry out self-managementmore scientifically and effectively.[Key words]Osteoarthritis,Knee;Self-Management;Evidence-Based Nursing骨关节炎是一种与年龄相关的关节退行性疾加患者心血管事件、下肢静脉血栓栓塞及全因死亡病,常常出现关节软骨变性、磨损、消失,关节边缘骨的风险。由于KOA是慢性退行性疾病,一旦发病,赘形成等病理变化,最终关节面完全破坏、关节畸不能完全治愈,给患者、家庭、社会都带来巨大负担。形,甚至导致患者残疾山。该病多见于老年人群,好研究6显示,有效的患者自我管理如合适的运动和发于负重较大的膝关节、髋关节等部位,其中膝关节体重控制等能够减轻膝关节疼痛、预防关节活动受发病率最高四),已成为国内老年患者疼痛和残疾的限、提高患者的生活质量。国外指南)也建议将健主要原因。随着我国老龄化的日益加剧,膝骨关节炎康宜教、运动及体重管理等自我管理措施纳入KOA(knee osteoarthritis,KOA)的发病率不断上升,据报核心干预方法,然而目前相关证据较为分散,尚未形告,我国中老年人K0A发病率高达36.4%。K0A不成系统的针对KOA自我管理的最佳证据和推荐意仅导致患者疼痛、关节活动受限、关节畸形,还会增见,不利于医护人员进行基于循证的自我管理指导。因此,本文基于系统检索并汇总KOA患者自我管理D0:10.3761issn.02541769.2023.06.014的最佳证据,以期为医护人员指导患者进行自我管作者单位:310053杭州市浙江中医药大学护理学院理提供依据。通信作者:王俊杰,E-ml:wjie2000@163.com单雪琪:女,本科(硕士在读),E-il:1269641669@q阳com2022-07-29收稍1资料与方法Chin J Nurs,March 2023,Vol.58,No.6735(C)1994-2023 China Academic Journal Electronic Publishing House.All rights reserved.http://www.cnki.net