中华护理杂志 ›› 2023, Vol. 58 ›› Issue (14): 1704-1711.DOI: 10.3761/j.issn.0254-1769.2023.14.006
收稿日期:
2022-08-12
出版日期:
2023-07-20
发布日期:
2023-07-14
通讯作者:
闫金凤,E-mail:275292485@qq.com作者简介:
刘洁:女,硕士,护师,E-mail:1179285375@qq.com
基金资助:
LIU Jie(), YAN Jinfeng(
), HAN Peng, ZHAO Rong
Received:
2022-08-12
Online:
2023-07-20
Published:
2023-07-14
摘要:
目的 通过网状Meta分析评价8种康复疗法对颈淋巴结清扫术后患者颈肩功能的影响。方法 检索中英文数据库中关于康复训练对颈淋巴结清扫术后患者颈肩功能影响的随机对照试验,检索时限为建库至2022年4月,由2名研究者独立进行检索及资料提取。采用Review Manager 5.3进行文献质量评价,采用ADDIS1.16.8软件进行网状Meta分析。结果 纳入22项随机对照试验,共1 407例患者,8种康复疗法。网状Meta分析结果表明,在肩关节功能评价指标方面,术中神经肌肉电刺激(P=0.040)、颈肩有氧操(P=0.020)、阶梯式联合运动(有氧运动+抗阻运动)(P=0.009)、太极拳(P=0.040)、针灸(P=0.030)优于常规康复方法;在颈淋巴结清扫损伤指数方面,仅针灸(P=0.020)优于常规康复方法;在肩关节疼痛和功能恢复评价指标方面,仅阶梯式联合运动(有氧运动+抗阻运动)(P=0.030)优于常规康复方法;在肩部活动度(肩屈曲、肩外展)方面,各运动类型间两两比较,差异均无统计学意义(P>0.05);在颈部向患侧屈曲方面,阶梯式联合运动(有氧运动+抗阻运动)(P=0.004)、颈肩有氧操(P=0.008)、太极拳(P=0.006)、穴位疗法(P=0.010)优于常规康复方法;在颈部向健侧屈曲方面,颈肩有氧操(P=0.040)、穴位疗法(P=0.030)优于常规康复方法;在颈部向健侧旋转方面,颈肩有氧操(P=0.020)优于常规康复方法;在颈部向患侧旋转方面,颈肩有氧操(P=0.030)优于常规康复方法。结论 8种康复疗法中针灸主要在降低患者肩部疼痛,提高其参与社会活动能力方面,阶梯式联合运动(有氧运动+抗阻运动)主要在恢复患者肩关节功能障碍方面,颈肩有氧操主要在提高患者颈部活动度方面各自具有优势,但该研究存在一定的局限性,结论仍需进一步验证。
刘洁, 闫金凤, 韩鹏, 赵蓉. 不同康复疗法对颈淋巴结清扫术后患者颈肩功能影响的网状Meta分析[J]. 中华护理杂志, 2023, 58(14): 1704-1711.
LIU Jie, YAN Jinfeng, HAN Peng, ZHAO Rong. Effect of different rehabilitation therapies on neck and shoulder function of patients after neck dissection:a network meta-analysis[J]. Chinese Journal of Nursing, 2023, 58(14): 1704-1711.
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表2 8种康复疗法对颈淋巴结清扫术后患者各指标影响的概率排序结果
Table 2 Probability ranking results of the influence of 8 rehabilitation interventions on each index of patients after neck dissection
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