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结构化运动与不运动对无症状主动脉瘤的有效性和安全性:系统评价与荟萃分析

Effectiveness and safety of structured exercise vs. no exercise for asymptomatic aortic aneurysm: systematic review and meta-analysis.

作者信息

Oliveira Ricardo de Ávila, Nakajima Eliza, de Vasconcelos Vladimir Tonello, Riera Rachel, Baptista-Silva José Carlos Costa

机构信息

Universidade Federal de Uberlândia - UFU, Departamento de Cirurgia, Uberlândia, MG, Brasil.

Universidade Federal de São Paulo - UNIFESP, Departamento de Medicina, São Paulo, SP, Brasil.

出版信息

J Vasc Bras. 2020 May 8;19:e20190086. doi: 10.1590/1677-5449.190086.

Abstract

We conducted a systematic review to compare the effectiveness and safety of exercise versus no exercise for patients with asymptomatic aortic aneurysm. We followed the guidelines set out in the Cochrane systematic review handbook. We searched Medline, Embase, CENTRAL, LILACS, PeDRO, CINAHL, clinicaltrials.gov, ICTRP, and OpenGrey using the MeSH terms "aortic aneurysm" and "exercise". 1189 references were identified. Five clinical trials were included. No exercise-related deaths or aortic ruptures occurred in these trials. Exercise did not reduce the aneurysm expansion rate at 12 weeks to 12 months (mean difference [MD], -0.05; 95% confidence interval [CI], -0.13 to 0.03). Six weeks of preoperative exercise reduced severe renal and cardiac complications (risk ratio, 0.54; 95% CI, 0.31-0.93) and the length of intensive care unit stay (MD, -1.00; 95% CI, -1.26 to -0.74). Preoperative and postoperative forward walking reduced the length of hospital stay (MD, -0.69; 95% CI, -1.24 to -0.14). The evidence was graded as 'very low' level.

摘要

我们进行了一项系统评价,以比较运动与不运动对无症状主动脉瘤患者的有效性和安全性。我们遵循了Cochrane系统评价手册中规定的指南。我们使用医学主题词“主动脉瘤”和“运动”在Medline、Embase、CENTRAL、LILACS、PeDRO、CINAHL、clinicaltrials.gov、ICTRP和OpenGrey中进行检索。共识别出1189篇参考文献。纳入了5项临床试验。这些试验中未发生与运动相关的死亡或主动脉破裂。运动在12周内至12个月时并未降低动脉瘤扩张率(平均差[MD],-0.05;95%置信区间[CI],-0.13至0.03)。术前6周的运动减少了严重的肾脏和心脏并发症(风险比,0.54;95%CI,0.31 - 0.93)以及重症监护病房住院时间(MD,-1.00;95%CI,-1.26至-0.74)。术前和术后向前行走减少了住院时间(MD,-0.69;95%CI,-1.24至-0.14)。证据等级为“极低”级别。

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