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呼吸锻炼对肺癌术后患者肺功能及生活质量影响的系统评价与Meta分析

Systematic review and meta-analysis of breathing exercises effects on lung function and quality of life in postoperative lung cancer patients.

作者信息

Ren Jiayi, Li Zongyue, He Yuchen, Gao Hang, Li Jin, Tao Jiming

机构信息

Department of Rehabilitation Medicine, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Department of Rehabilitation Medicine, Zhongshan Hospital Fudan University, Shanghai, China.

出版信息

J Thorac Dis. 2024 Jul 30;16(7):4295-4309. doi: 10.21037/jtd-23-1733. Epub 2024 Jul 26.

Abstract

BACKGROUND

Postoperative recovery in lung cancer patients is a complex process, where breathing exercises may play a crucial role in enhancing pulmonary function and quality of life (QoL). This study systematically reviews and meta-analyzes the impact of breathing exercises on post-surgical lung function and QoL in lung cancer patients.

METHODS

An extensive literature search was conducted across PubMed, Cochrane, Web of Science, and Embase databases using terms like "Lung Neoplasms", "breathing exercises", and "randomized controlled trial", supplemented by Medical Subject Headings (MeSH) and free words. The Cochrane risk of bias tool was used for quality assessment. A systematic review and meta-analysis on the effects of breathing exercises post-lung cancer surgery followed by data extraction and quality evaluation.

RESULTS

From 384 retrieved studies, 10 met the inclusion criteria and were selected for detailed analysis. The main outcomes assessed were postoperative pulmonary function indices and QoL measures. The majority of studies were deemed 'low risk' for random sequence generation and allocation concealment. However, due to the nature of the interventions, blinding was a 'high risk' in most cases. The meta-analysis revealed significant improvements in key pulmonary function indices: forced vital capacity (FVC%) increased by an average of 1.73%, maximal voluntary ventilation (MVV) improved by 7.58 L/min, and maximal inspiratory pressure (MIP) enhanced by 0.95 cmHO. Additionally, there was a notable alleviation of postoperative dyspnea and an enhancement in QoL, with anxiety scores decreasing by an average of 3.42 points and complication rates reducing correspondingly. However, the interventions did not significantly affect physical activity levels or performance on the 6-minute walk test (6WMT), with effect sizes for these outcomes being non-significant.

CONCLUSIONS

This study indicates that breathing exercises significantly improve postoperative pulmonary function and QoL in lung cancer patients. Future research should delve into the mechanisms behind these exercises and evaluate their long-term rehabilitation effects. Customized programs could further optimize recovery and enhance patient QoL.

摘要

背景

肺癌患者的术后恢复是一个复杂的过程,呼吸锻炼可能在增强肺功能和提高生活质量(QoL)方面发挥关键作用。本研究系统评价并荟萃分析了呼吸锻炼对肺癌患者术后肺功能和生活质量的影响。

方法

在PubMed、Cochrane、科学网和Embase数据库中进行广泛的文献检索,使用“肺肿瘤”“呼吸锻炼”和“随机对照试验”等术语,并辅以医学主题词(MeSH)和自由词。采用Cochrane偏倚风险工具进行质量评估。对肺癌手术后呼吸锻炼的效果进行系统评价和荟萃分析,随后进行数据提取和质量评估。

结果

从检索到的384项研究中,10项符合纳入标准并被选入进行详细分析。评估的主要结局是术后肺功能指标和生活质量测量。大多数研究在随机序列生成和分配隐藏方面被认为“低风险”。然而,由于干预措施的性质,在大多数情况下,盲法是“高风险”。荟萃分析显示关键肺功能指标有显著改善:用力肺活量(FVC%)平均增加1.73%,最大自主通气量(MVV)提高7.58 L/分钟,最大吸气压力(MIP)增强0.95 cmH₂O。此外,术后呼吸困难明显减轻,生活质量提高,焦虑评分平均降低3.42分,并发症发生率相应降低。然而,这些干预措施对身体活动水平或6分钟步行试验(6WMT)的表现没有显著影响,这些结局的效应大小不显著。

结论

本研究表明,呼吸锻炼可显著改善肺癌患者的术后肺功能和生活质量。未来的研究应深入探究这些锻炼背后的机制,并评估其长期康复效果。定制方案可进一步优化恢复并提高患者生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550b/11320241/c0de6d50ee0a/jtd-16-07-4295-f1.jpg

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