早期活动对肺癌患者术后康复及生活质量影响的Meta分析

doi:10.3761/j.issn.0254-1769.2022.17.008

摘要/Abstract

摘要：

目的通过Meta分析评价早期活动对肺癌患者术后康复及生活质量的影响。方法系统检索PubMed、Embase、Cochrane Library、CINAHL、Web of Science、中国期刊全文数据库、万方数据库、维普数据库、中国生物医学文献数据库中关于肺癌患者术后早期活动的随机对照试验和类实验研究,检索时限为建库至2021年12月,采用Revman 5.2软件进行Meta分析。结果共纳入13篇文献,包括1 786例患者。Meta分析结果显示,早期活动可缩短胸腔引流管留置时间[MD=-1.13,95%CI（-1.27,-0.99）,P<0.001]、降低肺癌患者术后并发症发生率[RR=0.66,95%CI（0.53,0.83）,P<0.001]及减少住院时间[MD=-1.21,95%CI（-1.95,-0.46）,P=0.002];当早期活动结合家庭运动干预时,可进一步改善肺癌患者的肺功能[SMD=0.57,95%CI（0.29,0.86）,P<0.001]、延长6 min步行距离[MD=125.36,95%CI（41.46, 209.26）,P=0.003],但在改善肺癌患者生活质量方面,差异无统计学意义[SMD=0.11,95%CI（-0.14,0.36）,P=0.400]。结论术后早期活动可改善肺癌患者多项康复指标,当在术后早期活动基础上额外增加家庭运动干预后,可改善肺癌患者肺功能、延长6 min步行距离,但在改善肺癌患者健康相关生活质量方面效果不显著。

关键词: 肺肿瘤, 早期活动, 康复护理, 生活质量, Meta分析, 循证护理学

Abstract:

Objective To systematically evaluate the effect of early mobilization on postoperative rehabilitation and quality of life of lung cancer patients. Methods We searched databases including PubMed,Embase,the Cochrane Library,CINAHL,Web of Science,China National Knowledge Infrastructure（CNKI）,Wanfang Database,SinoMed,China Science and Technology Journal Database,and all randomized controlled trials（RCTs） or quasi-experimental studies that reported the effects of early mobilization in lung cancer patients were retrieved. The retrieval time is from the establishment of the database to December 2021. Meta-analysis was performed by RevMan 5.2. Results A total of 13 studies involving 1 786 patients were finally included. The meta-analysis showed that early mobilization shortened the duration of chest drain retention[MD=-1.13,95%CI（-1.27,-0.99）,P<0.001], reduced the incidence of postoperative complications[RR=0.66,95%CI（0.53,0.83）,P<0.001] and reduced the length of hospital stay in lung cancer patients[MD=-1.21,95%CI（-1.95,-0.46）,P=0.002]. When early mobilization was combined with home exercise intervention,it improved lung function[SMD=0.57,95%CI（0.29,0.86）,P<0.001],pro-longed 6-min walking distance[MD=125.36,95%CI（41.46,209.26）,P=0.003],but the difference was not statistically significant in improving the quality of life of lung cancer patients[SMD=0.11,95%CI（-0.14,0.36）,P=0.400]. Conclusion Early mobilization improved several recovery indicators in lung cancer patients. When additional home exer-cise intervention was added to early mobilization,it improved lung function and prolonged 6-min walking distance in lung cancer patients,but it was not significant in improving health-related quality of life in lung cancer patients.

Key words: Lung Neoplasms, Early Mobilization, Rehabilitation Nursing, Quality of Life, Meta-Analysis, Evidence-Based Nursing

杨洁, 刘晓芯, 居馨星, 成钰娜, 谷艳. 早期活动对肺癌患者术后康复及生活质量影响的Meta分析[J]. 中华护理杂志, 2022, 57(17): 2095-2101.

YANG Jie, LIU Xiaoxin, JU Xinxing, CHENG Yuna, GU Yan. Effect of early mobilization on postoperative rehabilitation and quality of life of lung cancer patients：a meta analysis[J]. Chinese Journal of Nursing, 2022, 57(17): 2095-2101.

图/表 5

表1 纳入文献的基本特征（n=13）

Table 1 Characteristics of included studies（n=13）

表2 随机对照试验的文献质量评价结果（n=7）

Table 2 Methodological quality evaluation of 7 included randomized controlled trials（n=7）

表3 类实验研究文献质量评价结果（n=6）

Table 3 Methodological quality evaluation of 6 included quasi-experimental studies（n=6）

图1 早期活动对肺癌患者术后胸腔引流管留置时间的影响

Figure 1 Effect of early mobilization on postoperative thoracic drainage tube indwelling time in patients with lung cancer

图2 早期活动对肺癌患者术后并发症发生率的影响

Figure 2 The effect of early mobilization on the incidence of postoperative complications in patients with lung cancer

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