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肺康复训练对接受胸腔镜部分肺切除术的肺癌患者术后恢复的影响:一项荟萃分析

Effect of pulmonary rehabilitation training on postoperative recovery in lung cancer patients undergoing thoracoscopic partial pulmonary resection: a meta-analysis.

作者信息

Duan Tianyun, Guo Yinan, Lu Qin, Pan Hongying

机构信息

Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Hangzhou 310016, Zhejiang, China.

Medical Department, Hangzhou Red Cross Hospital Hangzhou 310003, Zhejiang, China.

出版信息

Am J Transl Res. 2024 Nov 15;16(11):6168-6186. doi: 10.62347/NJRM6592. eCollection 2024.

Abstract

OBJECTIVE

To systematically analyze the impact of pulmonary rehabilitation (PR) on postoperative recovery of lung cancer patients undergoing thoracoscopic partial pulmonary resection.

METHODS

This study has been registered with PROSPERO (CRD42024574965). A comprehensive search was conducted in PubMed, The Cochrane Library, Embase, Web of Science and CINAHL for literature on the effects of PR on postoperative rehabilitation in lung cancer patients undergoing thoracoscopic partial pulmonary resection, up to May 2024. Studies meeting the inclusion and exclusion criteria were selected for the meta-analysis. Valid data were extracted, and the integrated analysis was performed using RevMan5.3 and Stata 12.0 software.

RESULTS

A total of 10 relevant studies, involving 677 subjects, were included. Of these, 341 patients were in the experimental group, and 336 were in the control group. The meta-analysis showed that PR significantly improved the forced expiratory volume in the first second after surgery (FEV1) [=1.73, 95% CI: (0.52-2.94)], peak expiratory flow (PEF) [=0.45, 95% CI: (0.12-0.78)], forced vital capacity (FVC) [SMD=4.31, 95% CI: (1.98-6.63)], and 6 min walking distance (6MWD) [=1.64, 95% CI: (0.64-2.65)]. PR also reduced the incidence of postoperative complications [=0.28, 95% CI: (0.18-0.43)] and shortened the duration of postoperative hospitalization [=-0.56, 95% CI: (-0.88 - -0.24)] in lung cancer patients undergoing thoracoscopic partial pulmonary resection. There was no significant difference in anxiety [=-0.34, 95% CI: (-1.27-0.60)] or depression [=-0.15, 95% CI: (-0.48-0.18)] between the two groups.

CONCLUSION

PR improves lung function and exercise tolerance, reduces postoperative complications, and shortens postoperative hospital stays in lung cancer patients undergoing thoracoscopic partial pulmonary resection. However, its effect on reducing negative mood remains unclear. Due to the limitations in the number and quality of included studies, further high-quality studies are needed to validate these findings.

摘要

目的

系统分析肺康复(PR)对接受胸腔镜下部分肺切除术的肺癌患者术后恢复的影响。

方法

本研究已在PROSPERO(CRD42024574965)注册。截至2024年5月,在PubMed、Cochrane图书馆、Embase、Web of Science和CINAHL中全面检索关于PR对接受胸腔镜下部分肺切除术的肺癌患者术后康复影响的文献。选择符合纳入和排除标准的研究进行荟萃分析。提取有效数据,并使用RevMan5.3和Stata 12.0软件进行综合分析。

结果

共纳入10项相关研究,涉及677名受试者。其中,341例患者在实验组,336例在对照组。荟萃分析表明,PR显著改善了术后第一秒用力呼气量(FEV1)[=1.73,95%CI:(0.52 - 2.94)]、呼气峰值流速(PEF)[=0.45,95%CI:(0.12 - 0.78)]、用力肺活量(FVC)[SMD = 4.31,95%CI:(1.98 - 6.63)]和6分钟步行距离(6MWD)[=1.64,95%CI:(0.64 - 2.65)]。PR还降低了接受胸腔镜下部分肺切除术的肺癌患者术后并发症的发生率[=0.28,95%CI:(0.18 - 0.43)],并缩短了术后住院时间[=-0.56,95%CI:(-0.88 - -0.24)]。两组之间在焦虑[=-0.34,95%CI:(-1.27 - 0.60)]或抑郁[=-0.15,95%CI:(-0.48 - 0.18)]方面无显著差异。

结论

PR可改善接受胸腔镜下部分肺切除术的肺癌患者的肺功能和运动耐力,减少术后并发症,并缩短术后住院时间。然而,其对减轻负面情绪的作用仍不明确。由于纳入研究的数量和质量有限,需要进一步的高质量研究来验证这些结果。

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本文引用的文献

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Mechanisms of exercise in the treatment of lung cancer - a mini-review.运动治疗肺癌的机制——小型综述。
Front Immunol. 2023 Aug 24;14:1244764. doi: 10.3389/fimmu.2023.1244764. eCollection 2023.
8
Pulmonary rehabilitation and physical interventions.肺康复和物理干预。
Eur Respir Rev. 2023 Jun 7;32(168). doi: 10.1183/16000617.0222-2022. Print 2023 Jun 30.

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