阻塞性睡眠呼吸暂停成人患者运动干预的最佳证据总结

Evidence summary of exercise training for adult patients with obstructive sleep apnea

目的总结成人阻塞性睡眠呼吸暂停患者运动干预的最佳证据,为临床实践提供循证依据。方法检索BMJ、JBI、Cochrane Library、PubMed、国际指南协作网、美国国立指南库、英国国家卫生与临床优化研究所、Web of Science、CINAHL、中国知网、中国生物医学数据库、万方数据库、医脉通等数据库中有关成人阻塞性睡眠呼吸暂停患者运动干预的相关文献,主要包括指南、专家共识、系统评价和随机对照试验,检索时限为建库至2021年12月,采用JBI循证卫生保健中心的文献质量评价标准和证据分级系统对纳入文献进行质量评价和分级汇总。结果最终纳入8篇文献,包括3篇指南、2篇系统评价和3篇随机对照试验。总结了包括适用人群、运动类型、运动频率与时间、运动强度、运动原则和质量控制6个类别的15条证据。结论本研究证据总结过程较为具体、全面、科学,可为成人阻塞性睡眠呼吸暂停患者运动干预提供指导。但医护人员在应用证据时要充分考虑国内外医疗服务系统、价值观念和文化的差异以及患者的自身情况,为患者制订个性化的运动方案。

Objective Summarize the best evidence of exercise training in adult patients with obstructive sleep apnea(OSA)to provide reference for clinical practice.Methods The relative literatures of BMJ,JBI,Cochrane Library,PubMed,GIN,NGC,NICE,Web of Science,CINAHL,CNKI,SinoMed,Wanfang,Medlive were retrieved in exercise training from the establishment of the databases to December 2021 for adult patients with OSA.Clinical guidelines,expert consensus,systematic reviews and randomized controlled trials were included.The quality of literature was evaluated,classified,and summarized by literature quality evaluation criteria and evidence grading system of JBI evidence-based health care centers.Results In total,nine articles were included,including three guidelines,three systematic reviews and three randomized controlled trials.Fifteen pieces of evidence were summarized in six areas,namely applicable population,exercise type,exercise frequence and time,exercise intensity,exercise principle,and quality control.Conclusion The evidence summarization process of this study is specific,comprehensive and scientific,and can provide guidance for exercise intervention in adult patients with OSA.Meanwhile,medical staffs should fully consider the differences between domestic and overseas in medical service systems,values and cultures,as well as patients’own conditions to develop personalized exercise training programs when applying evidence.