呼吸肌锻炼对心胸腹部手术患者康复结局影响的Meta分析

Respiratory muscle training on the rehabilitation of patients undergoing cardiothoracic and abdominal surgery： a Meta-analysis

目的 评价呼吸肌训练器行呼吸肌锻炼对心胸腹部术后患者康复结局的影响.方法计算机检索CINAHL、MEDLINE、PubMed、EBSCO和中国期刊全文数据库（CNKI）、万方数据库、维普中文科技期刊数据库（VIP）中关于心胸腹部手术患者使用呼吸肌训练器促进患者康复的随机对照试验.由2名研究者独立对文献质量进行严格评价和资料提取,对纳入研究进行Meta分析.结果最终纳入12篇随机对照研究,1060例患者,Meta分析的结果显示,使用呼吸肌训练器进行呼吸肌锻炼有助于增强呼吸肌力（SMD=0.70,95%CI 0.15～1.24）;改善患者术后肺功能：（用力肺活量：SMD=0.48,95%CI 0.10～0.87;吸气肺活量：SMD=0.55,95%CI 0.07～1.04）;显著降低心胸腹部手术后患者肺部并发症（OR=0.21,95%CI 0.15～0.31）;减少患者住院天数（SMD=-0.52,95%CI-0.87～-0.16）,P值均＆lt;0.05.结论使用呼吸肌训练器进行呼吸肌锻炼能促进心胸腹部手术患者康复.

Objective To systematically evaluate the effects of respiratory muscle training by using respiratory muscle training device on rehabilitation of people undergoing cardiothoracic and abdominal surgery. Methods The relevant randomized controlled trials were searched in the databases of the CINAHL, Medline, PubMed, EBSCO, China National Knowledge Infrastructure （CNKI）, Wanfang Data, VIP. The quality of studies was critically appraised and data were extracted by two reviewers independently, a meta-analysis was conducted for the included studies. Results Finally 12 randomized controlled trial involving 1060 patients were included. Meta-analysis showed that respiratory muscle training device could improve respiratory muscle strength [SMD =0.70, 95%CI （0.15-1.24）]; improved lung function [forced vital capacity：SMD=0.48, 95%CI （0.10-0.87）;inspiratory capacity：SMD=0.55, 95%CI （0.07-1.04）]; improve; effectively reduced postoperative pulmonary complications [OR=0.21, 95%CI：（0.15-0.31）]; shorten the length of hospital stays [SMD=-0.52, 95%CI （-0.87--0.16）], all P＆lt; 0.05. Conclusions The application of respiratory muscle training with respiratory muscle device could promote the rehabilitation of patients undergoing cardiothoracic and abdominal surgery.