预康复对心外科择期手术患者术后恢复影响的Meta分析

Effects of pre-rehabilitation on postoperative recovery of patients undergoing elective cardiac surgery:a Meta-analysis

目的通过Meta分析明确预康复对心外科择期手术患者术后恢复的影响。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、Medline、CNKI、万方、维普和中国生物医学文献数据库中公开发表的预康复应用于心外科择期手术患者的随机对照试验,检索时限为建库至2021年1月1日。由2名评价人员按照纳入与排除标准独立进行文献筛选、资料提取和文献质量评价后,采用RevMan 5.4软件进行Meta分析。结果共纳入文献13篇,包括研究对象1542例。Meta分析结果显示,术前预康复对降低心外科择期手术患者术后并发症[Z=4.79,RR=0.57,95%CI(0.45,0.72),P<0.01]、提高患者6 min步行试验距离[Z=5.21,SMD=0.51,95%CI(0.32,0.70),P<0.01]和最大吸气压[Z=4.16,SMD=0.76,95%CI(0.40,1.12),P<0.01]具有积极影响。结论预康复可有效降低心外科择期手术患者术后并发症的发生率,提高患者术后6 min步行试验距离和最大吸气压。

Objective To explore the effect of pre-rehabilitation on postoperative recovery of patients undergoing elective cardiac surgery through Meta-analysis.Methods Randomized controlled trials of pre-rehabilitation in patients undergoing elective cardiac surgery were retrieved by computer in PubMed,Web of Science,Cochrane Library,Embase,Medline,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP and China Biomedical Literature Database.The retrieval time limit was from the establishment of the database to January 1,2021.Two reviewers independently conducted literature screening,data extraction and literature quality evaluation according to the inclusion and exclusion criteria.Meta-analysis was performed using RevMan 5.4.Results A total of 13 articles were included,including 1542 subjects.Meta-analysis results showed that preoperative rehabilitation had positive effects on reducing postoperative complications in patients undergoing elective cardiac surgery[Z=4.79,RR=0.57,95%CI(0.45,0.72),P<0.01],and increasing the distance of 6-minute walking test[Z=5.21,SMD=0.51,95%CI(0.32,0.70),P<0.01]and maximum inspiratory pressure[Z=4.16,SMD=0.76,95%CI(0.40,1.12),P<0.01].Conclusions Pre-rehabilitation can effectively reduce the incidence of postoperative complications in patients undergoing elective cardiac surgery,and increase the postoperative 6-minute walking test distance and maximum inspiratory pressure.