摘要
目的通过Meta分析比较常规治疗联合术前肺康复和单纯常规治疗对肺癌患者术后恢复的影响,明确术前肺康复临床应用的有效性,为今后术前肺康复广泛应用于肺癌患者提供有效证据。方法分别在中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Cochrane Library、Clinical Science、Web of Science等数据库根据既定的检索词检索肺癌肺康复的相关文献,将时间限定为各数据库建库至2019年1月。然后根据纳入和排除标准筛选出最终进行Meta分析的文献,最后从所选文献中提取出研究所需的资料,并采用RevMan 5.0软件进行整合分析。结果根据纳入标准和排除标准最终确定对11篇文献进行Meta分析,共计658例研究对象,均为诊断明确且准备接受择期手术治疗的肺癌患者,试验组307例,对照组351例。Meta分析结果显示术前肺康复训练组的肺癌患者术后肺功能水平用力肺活量[MD=0.31,95%CI(0.21,0.42),P<0.01]、第1秒用力呼气容积[MD=0.27,95%CI(0.20,0.34),P<0.01]、活动耐量6分钟步行距离[MD=50.55,95%CI(35.98,65.13),P<0.01]水平明显优于常规治疗组,术后并发症的发生率更低[MD=0.28,95%CI(0.18,0.43),P<0.01],术后住院时间明显缩短[MD=–2.09,95%CI(–2.41,–1.77),P<0.01]。结论术前肺康复训练可以改善肺癌患者的术后肺功能及活动耐量,减少术后并发症和住院时间,有利于术后的恢复。
Objective To clarify the effectiveness of preoperative pulmonary rehabilitation(PPR)and provide evidence for the application of PPR on lung cancer patients by meta-analysis.Methods According to inclusion and exclusion criteria,literatures related to PPR on lung cancer patients were retrieved from major databases between the date of establishment of each database and January 2019,and then data required were extracted from the selected literatures.Meta-analysis was conducted by RevMan 5.0.Results Twelve randomized controlled trials were involved in metaanalysis,including 658 patients who were well-diagnosed and prepared for surgery,with 307 patients in the PPR group and 351 patients in the control group.The results of the meta-analysis showed that in the PPR group,the pulmonary function including forced vital capacity[MD=0.31,95%CI(0.21,0.42),P<0.01],forced expiratory volume in one second[MD=0.27,95%CI(0.20,0.34),P<0.01]and activity tolerance including 6-minute walk distance[MD=50.55,95%CI(35.98,65.13),P<0.01]were significantly better than the control group,and the postoperative complication rate was lower[MD=0.28,95%CI(0.18,0.43),P<0.01],postoperative hospital stay was shorter[MD=–2.09,95%CI(–2.41,–1.77),P<0.01].Conclusions A period of PPR on lung cancer patients can improve postoperative pulmonary function and activity tolerance,and reduce postoperative complications and hospital stay,which is beneficial to postoperative recovery.
作者
陈卫海
励建安
许彬
吴雁鸣
沈峻
倪隽
尤华
CHEN Weihai;LI Jian’an;XU Bin;WU Yanming;SHEN Jun;NI Jun;YOU Hua(Department of Cardiology,Suzhou Ninth People’s Hospital,Suzhou,Jiangsu 215200,P.R.China;Department of Rehabilitation,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210000,P.R.China;Nursing Department,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210000,P.R.China;Department of Rehabilitation,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226000,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2020年第6期568-576,共9页
Chinese Journal of Respiratory and Critical Care Medicine
基金
江苏省科技计划项目(201808995-SBE2018750244)。
关键词
肺癌
术前肺康复
META分析
Lung cancer
Preoperative pulmonary rehabilitation
Meta-analysis
