AECOPD病人早期肺康复运动训练的最佳证据总结

Summary of the best evidence of early pulmonary rehabilitation exercise training for AECOPD patients

目的:检索、评价并总结慢性阻塞性肺疾病急性加重(AECOPD)病人早期肺康复运动训练最佳证据,为临床提供参考。方法:计算机检索BMJ Best Practice、Up To Date、WHO、国际指南协作网、苏格兰指南网、加拿大安大略省护士协会、临床实践指南、英国国家卫生与临床优化研究所、医脉通、JBI证据总结数据库+、the Cochrane Library、PubMed、EMbase、中国知网、万方数据库、中国生物医学文献数据库(CBM)及美国胸科协会、澳大利亚和新西兰胸科协会、加拿大胸科协会、英国胸科协会、欧洲呼吸学会等关于AECOPD肺康复运动的相关证据,包括临床决策、指南、证据总结、系统评价、随机对照试验(RCT)等,检索时限自建库至2021年11月20日。由2名研究者对文献质量进行独立评价,同时提取和汇总相关证据。结果:共纳入21篇文献,包括1篇临床决策、6篇指南、2篇专家共识、7篇系统评价、5篇随机对照试验。最终形成包括运动的益处、时机、运动前评估及相关工具、禁忌证、运动处方、运动安全、运动过程呼吸策略、运动过程氧疗与教育9个方面,共23条最佳证据。结论:总结了AECOPD病人早期肺康复运动的最佳证据,形成具体的推荐意见,可为临床工作者制定相关运动训练方案提供循证依据。

Objective:To search,evaluate and summarize the best evidence of early pulmonary rehabilitation exercise training in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to provide reference for clinical practice.Methods:Evidence for AECOPD pulmonary rehabilitation,Including clinical decisions,guidelines,evidence summaries,systematic reviews,and RCTs were retrieved from BMJ Best Practice,Up To Date,WHO,GIN,SIGN,RNAO,Clinical Practice Guidelines,NICE,Yimaitong,JBI Connect+,The Cochrane Library,PubMed,EMbase,CNKI,WanFang Database,CBM,ATS,TSANZ,CTS,BTS,ERS,etc.The retrieval time limit was from the establishment of the database to November 20,2021.Two researchers independently evaluated the quality of the literature,and extracted and summarized relevant evidence.Results:A total of 21 articles were included,including 1 clinical decision,6 guidelines,2 expert consensus,7 systematic reviews,and 5 RCTs.The final formation includes 9 aspects of exercise benefits,timing,pre-exercise evaluation and related tools,contraindications,exercise prescription,exercise safety,respiratory strategy during exercise,oxygen therapy and education during exercise,with a total of 23 best evidences.Conclusion:The best evidence of early pulmonary rehabilitation exercise for AECOPD patients is summarized and specific recommendations are formed,which can provide evidence-based basis for clinical workers to formulate relevant exercise training programs.