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呼吸训练干预对肋骨骨折患者康复的影响:一项荟萃分析。

Effect of respiratory training intervention on rehabilitation of patients with rib fracture: a meta-analysis.

作者信息

Zhang Haidi, Ding Yadi, Ren Jiawei, Zhu Jianfang

机构信息

Department of Cardiothoracic Surgery, Yuecheng District, Shaoxing Second Hospital Medical Community General Hospital, No.123, Yan'an Road, Shaoxing, Zhejiang Province, 312000, China.

Department of Nursing, Shaoxing Second Hospital Medical Community General Hospital, Shaoxingaq, Zhejiang, 312000, China.

出版信息

BMC Sports Sci Med Rehabil. 2025 Mar 24;17(1):59. doi: 10.1186/s13102-025-01108-3.

Abstract

OBJECTIVE

To systematically evaluate the effectiveness of respiratory training interventions in the rehabilitation of patients with rib fractures through a meta-analysis, aiming to provide robust evidence for clinical practice.

METHODS

A comprehensive search was conducted in multiple databases (Pubmed, Embase, Web of Science, Cochrane Central, CNKI, Wanfang Data, and CSTJ) up to August 15, 2024, to identify relevant randomized controlled trials (RCTs). Eligible studies were those that compared RTIs plus conventional treatment with conventional treatment alone in patients with rib fractures. Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted using R Studio software, with relative risk (RR) and standardized mean difference (SMD) as effect sizes, accompanied by 95% confidence intervals (95% CI).

RESULTS

Nine RCTs involving 811 patients were included in the meta-analysis. Respiratory training interventions significantly reduced the incidence of atelectasis (RR = 0.23, 95% CI [0.13; 0.38]) and pulmonary infections (RR = 0.24, 95% CI [0.13; 0.44]), without significant heterogeneity between studies. Respiratory training interventions also shortened the length of hospital stay (SMD = -1.37, 95% CI [-1.57; -1.17]) and duration of chest tube drainage (SMD = -1.22, 95% CI [-1.43; -1.00]). Additionally, respiratory training interventions significantly improved arterial partial pressure of oxygen (PaO2) (SMD = 1.77, 95% CI [1.36; 2.18]) and arterial oxygen saturation (SaO2) (SMD = 1.92, 95% CI [1.49; 2.35]), and enhanced pulmonary function (SMD = 1.52, 95% CI [1.19; 1.84]). However, respiratory training interventions did not significantly affect the incidence of pleural effusions (RR = 1.09, 95% CI [0.49; 2.42]).

CONCLUSION

Respiratory training interventions significantly benefit patients with rib fractures by reducing atelectasis and pulmonary infections, shortening hospital stays and chest tube drainage times, and improving oxygenation and pulmonary function. Further high-quality studies are needed to confirm these findings and refine application strategies.

摘要

目的

通过荟萃分析系统评价呼吸训练干预在肋骨骨折患者康复中的有效性,旨在为临床实践提供有力证据。

方法

截至2024年8月15日,在多个数据库(PubMed、Embase、Web of Science、Cochrane Central、中国知网、万方数据和维普资讯)中进行全面检索,以识别相关的随机对照试验(RCT)。符合条件的研究是那些在肋骨骨折患者中比较呼吸训练干预联合传统治疗与单纯传统治疗的研究。由两名 reviewers 独立进行研究选择、数据提取和偏倚风险评估。使用R Studio软件进行荟萃分析,以相对风险(RR)和标准化均数差(SMD)作为效应量,并伴有95%置信区间(95%CI)。

结果

荟萃分析纳入了9项涉及811例患者的RCT。呼吸训练干预显著降低了肺不张的发生率(RR = 0.23,95%CI [0.13; 0.38])和肺部感染的发生率(RR = 0.24,95%CI [0.13; 0.44]),各研究间无显著异质性。呼吸训练干预还缩短了住院时间(SMD = -1.37,95%CI [-1.57; -1.17])和胸腔闭式引流时间(SMD = -1.22,95%CI [-1.43; -1.00])。此外,呼吸训练干预显著改善了动脉血氧分压(PaO2)(SMD = 1.77,95%CI [1.36; 2.18])和动脉血氧饱和度(SaO2)(SMD = 1.92,95%CI [1.49; 2.35]),并增强了肺功能(SMD = 1.52,95%CI [1.19; 1.84])。然而,呼吸训练干预对胸腔积液的发生率没有显著影响(RR = 1.09,95%CI [0.49; 2.42])。

结论

呼吸训练干预通过减少肺不张和肺部感染、缩短住院时间和胸腔闭式引流时间以及改善氧合和肺功能,使肋骨骨折患者显著受益。需要进一步的高质量研究来证实这些发现并完善应用策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae60/11931878/ae3a207199f4/13102_2025_1108_Fig1_HTML.jpg

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