运动干预在造血干细胞移植患儿中应用的范围综述

Exercise intervention in children with hematopoietic stem cell transplantation:a scoping review

目的系统检索国内外关于造血干细胞移植患儿移植期间运动干预的相关文献,归纳、总结运动干预的方法、效果、安全监测指标等内容,以期为临床实践提供参考。方法依据范围综述研究框架,系统检索Web of Science、PubMed、Scopus、Cochrane Library、Embase、CINAHL、中国知网、维普数据库、万方数据库和中国生物医学文献数据库,检索时限为建库至2023年5月19日。根据纳入及排除标准对文献进行筛选、汇总、提取、分析。结果共纳入17篇文献,其中随机对照试验5篇、类实验研究9篇、混合性研究3篇。造血干细胞移植患儿运动类型包括有氧运动、抗重力运动、抗阻运动以及拉伸运动;运动强度多为低至中等强度。干预效果显示,运动干预对患儿肌力、生活质量、心肺功能、人体成分、免疫功能等有积极影响。安全监测指标包括红细胞计数、血红蛋白浓度、血小板计数、体温、关节肌肉疼痛程度、跌倒及留置针脱落发生率等。结论运动干预在造血干细胞移植患儿中应用是安全可行的,对改善患儿肌力、生活质量等有积极影响。建议医护人员结合临床情景,制订合理、结构化的运动干预方案,并开展科学、规范化的运动管理。

Objective To systematically retrieve relevant research on the application of exercise intervention during hematopoietic stem cell transplantation for hospitalized children at home and abroad,to generalize and summarize the content of exercise intervention,the effect of intervention,and safety monitoring,with the purpose of providing reference bases for the clinical application of exercise intervention in the future.Methods In accordance with the scoping review framework,we systematically retrieved databases including Web of Science,PubMed,Scopus,Cochrane Library,Embase,CINAHL,CNKI,VIP Database,Wanfang Data and China Biomedical Literature Database,with a retrieval timeframe from database establishment to May 19,2023.Based on the criteria for inclusion and exclusion of literature,we screened,summarized,extracted,and analyzed the literature.Results A total of 17 pieces of literature were included,including 5 randomized controlled trials,9 quasi-experimental studies,and 3 mixed-method studies.There were 4 categories of exercise including aerobic,anti-gravity,resistance,and stretching;most of the exercises were of low to moderate intensity;the exercise interventions had a positive impact on muscle strength,quality of life,cardiorespiratory function,body composition,and hematological indices;the safety monitoring consisted of red blood cell,hemoglobin,and platelet counts,temperature,joint and muscle pains,as well as falls,and syringe shedding.Conclusion The application of exercise intervention is safe and feasible,with a positive effect on children with hematopoietic stem cell transplantation in muscle strength,quality of life.Medical staff should combine with the clinical situation to formulate a reasonable and unified exercise program and to carry out scientific and standardized exercise management.