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肺癌手术切除患者呼吸锻炼的影响:系统评价和荟萃分析。

Impact of breathing exercises in subjects with lung cancer undergoing surgical resection: A systematic review and meta-analysis.

机构信息

School of Nursing, Jilin University, Changchun, China.

出版信息

J Clin Nurs. 2019 Mar;28(5-6):717-732. doi: 10.1111/jocn.14696. Epub 2018 Nov 20.

Abstract

AIMS AND OBJECTIVES

To assess the effects of breathing exercises on postoperative pulmonary complications (PPCs), pulmonary function, 6-min walk distance (6MWD) and the length of hospital stay (LOS) in lung cancer patients undergoing lung surgery.

BACKGROUND

Lung cancer patients undergoing lung resection have poor pulmonary function and multiple PPCs. Breathing exercises may improve these symptoms.

DESIGN

Systematic literature review and meta-analysis were conducted.

METHODS

All entries to the following databases were searched up until 20 December 2017: PubMed, EMBASE Ovid, the Cochrane Central Register of Randomized Controlled Trials, Web of Science, Wanfang, Weipu and Chinese National Knowledge Infrastructure databases. Only randomised controlled trials (RCTs) were included in the analysis.

RESULTS

A total of sixteen articles including nine articles in Chinese language and seven articles in English met the inclusion criteria. Breathing exercises decreased PPCs, and in addition, the incidence of pneumonia and atelectasis in the postoperative subgroup was reduced. Predicted forced expiratory volume in 1 s (predicted FEV %), predicted forced vital capacity (predicted FVC%), FVC and FEV /FVC ratio had improved after breathing exercises, but the changes in FEV were not statistically significant. Furthermore, the LOS was significantly decreased, but no improvements were found in 6MWD.

CONCLUSIONS

The results showed that breathing exercises could improve lung function, decrease the incidence of PPCs and LOS in a sample of lung cancer patients undergoing pulmonary surgery.

RELEVANCE TO CLINICAL PRACTICE

The analysis suggests that breathing exercises should be considered as a respiratory rehabilitation programme for lung cancer patients undergoing lung surgery in clinical practice.

摘要

目的和目标

评估呼吸练习对肺癌患者术后肺部并发症(PPCs)、肺功能、6 分钟步行距离(6MWD)和住院时间(LOS)的影响。

背景

接受肺切除术的肺癌患者肺功能差,且有多种 PPCs。呼吸练习可能会改善这些症状。

设计

系统文献回顾和荟萃分析。

方法

检索了以下数据库截至 2017 年 12 月 20 日的所有条目:PubMed、EMBASE Ovid、Cochrane 中央随机对照试验注册中心、Web of Science、万方、维普和中国国家知识基础设施数据库。仅纳入分析随机对照试验(RCTs)。

结果

共有 16 篇文章符合纳入标准,其中 9 篇为中文,7 篇为英文。呼吸练习降低了 PPCs,此外,术后亚组中肺炎和肺不张的发生率降低。呼吸练习后预测的 1 秒用力呼气量(predicted FEV %)、预测的用力肺活量(predicted FVC %)、FVC 和 FEV/FVC 比值均有所改善,但 FEV 的变化无统计学意义。此外,LOS 明显缩短,但 6MWD 无改善。

结论

结果表明,呼吸练习可改善肺功能,降低肺癌患者肺部手术后 PPCs 和 LOS 的发生率。

临床意义

分析表明,呼吸练习应被视为肺癌患者肺手术后呼吸康复计划的一部分。

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