超早期康复对脑出血患者的临床疗效和安全性影响的系统评价

Effect of ultra-early rehabilitation on clinical efficacy and safety of patients with cerebral hemorrhage: a systematic review

目的系统评价超早期康复对脑出血患者临床疗效和安全性的影响。方法计算机检索PubMed、Embase、The Cochrane Library、WOS、CNKI、CBM、万方数据库,搜集有关脑出血超早期康复的随机对照试验(RCT),检索时限均从建库至2020年2月。采用Stata 12.0软件进行Meta分析。结果共检索到10 685篇文献,根据纳入与排除标准,最终纳入23篇RCT(中文15篇,英文8篇),包括2 435例患者。Meta分析结果显示:与常规治疗组相比,超早期康复组可改善神经功能缺损程度[WMD=-2.71,95%CI(-3.56,-1.86),P<0.01],提高日常生活能力[WMD=17.38,95%CI(13.89,20.87),P<0.01],提高肢体运动功能[WMD=18.97,95%CI(13.49,24.45),P<0.01]。结论超早期康复有利于脑出血患者神经功能的改善、日常生活能力及肢体运动功能的提高。

Objective To systematically evaluate the effect of ultra-early rehabilitation on clinical efficacy and safety of patients with cerebral hemorrhage.Methods PubMed, Embase, Cochrane Library, WOS,CNKI,CBM and Wanfang databases were electronically searched to collect randomized controlled trials(RCTs) of ultra-early rehabilitation on cerebral hemorrhage.The retrieval time was from the establishment of the databases to February 2020.Stata 12.0 software was used for Meta-analysis.Results A total of 10 685 articles were retrieved.According to the inclusion and exclusion criteria, 23 RCTs were included(15 in Chinese and 8 in English),involving 2 435 patients.Meta-analysis showed that ultra-early rehabilitation statistically decreased the degree of neurological deficit[WMD=-2.71,95%CI(-3.56,-1.86),P<0.01] and improved the activities of daily living [WMD=17.38,95%CI(13.89,20.87),P<0.01] and improred the limb motor function [WMD=18.97,95%CI(13.49,24.45),P<0.01] compared with conventional treatment.Conclusion Ultra-early rehabilitation is conducive to the improvement of neurological function, activities of daily living and limb motor function in patients with cerebral hemorrhage.