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多发伤康复的三个阶段——代表国际矫形与创伤外科学会(SICOT)的一项建议及系统文献综述

The three stages of polytrauma rehabilitation- a recommendation and a systematic literature review on behalf of SICOT.

作者信息

Klingebiel Felix Karl-Ludwig, Landre Vincent, Hasegawa Morgan, Kalbas Yannik, Hanschen Marc, Sawauchi Kenichi, Mohamed Sayid Omar, Zarti Mohammed, Zain-Ur-Rehmann Mohammad, Aroojis Alaric, Rajasekaran Shanmuganathan, Pape Hans-Christoph, Pfeifer Roman

机构信息

University of Zurich, Zurich, Switzerland.

Harald-Tscherne Laboratory for Orthopaedic and Trauma Research, University Hospital Zurich, Switzerland.

出版信息

Int Orthop. 2025 Feb;49(2):365-374. doi: 10.1007/s00264-024-06385-0. Epub 2024 Dec 16.

Abstract

PURPOSE

Polytrauma presents a devastating event with great impact on the patient's life. While we are taking great care of improving our treatment algorithms, the rehabilitation often takes place outside of our direct field of vision. Yet, adequate rehabilitation is crucial for the patients to regain their former lives. The aim of this study, on the behalf of SICOT Trauma & Rehabilitation Research Group, was to identify rehabilitation strategies and standards in existing scientific literature.

METHODS

A systematic literature search of MEDLINE and Embase from 2000 to 2023 was conducted. Inclusion criteria was the description of polytrauma rehabilitation strategies in the acute, post-acute or long-term stage. Reported treatment aims, conducted therapies and challenges were extracted and stratified to either of the stages.

RESULTS

A total of 5212 studies were identified and 6 reviews and one original study were included according to our criteria. Overall, no article of higher evidence on how to perform polytrauma rehabilitation could be identified. From the available literature, disciplines involved in the rehabilitation could be described such as major challenges along the rehabilitation process.

CONCLUSION

This study highlights the need for standardized polytrauma rehabilitation algorithms. Whereas we could identify important information about each rehabilitation stage, we did not encounter specific evidence for prioritization of different therapies or algorithms of treatment. Polytrauma rehabilitation needs to shift from eminence to evidence.

摘要

目的

多发伤是一种具有毁灭性的事件,对患者的生活产生重大影响。尽管我们在大力改进治疗算法,但康复过程往往在我们的直接视野之外进行。然而,充分的康复对于患者恢复以前的生活至关重要。本研究代表SICOT创伤与康复研究小组,旨在确定现有科学文献中的康复策略和标准。

方法

对2000年至2023年的MEDLINE和Embase进行系统的文献检索。纳入标准是对多发伤在急性、亚急性或长期阶段的康复策略进行描述。提取报告的治疗目标、实施的治疗方法和挑战,并按阶段进行分层。

结果

共识别出5212项研究,根据我们的标准纳入了6篇综述和1项原始研究。总体而言,未发现关于如何进行多发伤康复的更高证据的文章。从现有文献中,可以描述康复过程中涉及的学科以及主要挑战。

结论

本研究强调了标准化多发伤康复算法的必要性。虽然我们可以确定每个康复阶段的重要信息,但我们没有遇到关于不同治疗方法或治疗算法优先级的具体证据。多发伤康复需要从经验转向循证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3870/11762570/cc759ab0d072/264_2024_6385_Fig1_HTML.jpg

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