Lu Biao, Li Xiaobing, Jiang Hao
Department of Cardiothoracic Surgery, Shaoxing Central Hospital, Shaoxing, Zhejiang Province, 312030, China.
BMC Pulm Med. 2025 Aug 28;25(1):410. doi: 10.1186/s12890-025-03819-2.
Its objective was to use meta-analysis (MA) to methodically assess the impact of perioperative breathing exercises on the postoperative rehabilitation of patients with lung cancer (LC) having radical resection. METHODS: PubMed, and other databases were searched for randomized controlled trials on radical resection of LC combined with perioperative respiratory training from January 1995 to January 2024. After quality assessment, MA was performed using Review Manager 5.3 software.
A total of 14 studies involving 880 patients were included, of which 434 patients received perioperative breathing training (Intervention group, IG). The differences between the two groups in terms of MIP (MD = -13.31, 95% CI: [-24.43, -2.19]; Z = 2.35, P = 0.02), FVC (MD = -0.23, 95% CI = [-0.36, -0.11]; Z = 3.69, P = 0.0002), 6-minute walk test (6MWT) values (MD = 36.42, 95% CI: [4.37, 68.48]; Z = 2.23, P = 0.03), incidence of pneumonia (OR = 0.38, 95% CI = 0.20-0.72; Z = 2.95, P = 0.003), and complication rates (OR = 0.66, 95% CI = 0.46-0.94; Z = 2.29, P = 0.02) were statistically significant. However, there were no significant differences between the two groups in MEP (MD = -6.10, 95% CI: [-12.10, -0.11]; Z = 2.00, P = 0.05), FEV1 (MD = -0.25, 95% CI = [-0.58, 0.08]; Z = 1.47, P = 0.14), FEV1/FVC (MD = -3.78, 95% CI = [-7.65, 0.09]; Z = 1.91, P = 0.06), PEF (MD = -15.02, 95% CI = [-45.88, 15.83]; Z = 0.95, P = 0.34), atelectasis (OR = 0.52, 95% CI = 0.24-1.12; Z = 1.68, P = 0.09), pneumothorax (OR = 1.20, 95% CI = 0.63-2.29; Z = 0.57, P = 0.57), and mechanical ventilation incidence (OR = 0.99, 95% CI = 0.34-2.91; Z = 0.01, P = 0.99).
This MA demonstrates that perioperative respiratory training significantly improves MIP, FVC, and 6MWT in patients undergoing radical LC surgery, while effectively reducing the incidence of postoperative pneumonia and overall complications. However, its impact on MEP, certain pulmonary function parameters (FEV1, FEV1/FVC, PEF), and specific complications (atelectasis, pneumothorax, mechanical ventilation requirement) did not reach statistical significance. The findings support the inclusion of respiratory training in perioperative rehabilitation programs for LC patients to optimize postoperative recovery outcomes.
本研究旨在通过荟萃分析（MA）系统评估围手术期呼吸锻炼对接受根治性切除术的肺癌（LC）患者术后康复的影响。
检索PubMed及其他数据库中1995年1月至2024年1月关于LC根治性切除联合围手术期呼吸训练的随机对照试验。经过质量评估后，使用Review Manager 5.3软件进行MA。
共纳入14项研究，涉及880例患者，其中434例患者接受围手术期呼吸训练（干预组，IG）。两组在最大吸气压（MD = -13.31，95%CI：[-24.43，-2.19]；Z = 2.35，P = 0.02）、用力肺活量（MD = -0.23，95%CI = [-0.36，-0.11]；Z = 3.69，P = 0.0002）、6分钟步行试验（6MWT）值（MD = 36.42，95%CI：[4.37，68.48]；Z = 2.23，P = 0.03）、肺炎发生率（OR = 0.38，95%CI = 0.20 - 0.72；Z = 2.95，P = 0.003）及并发症发生率（OR = 0.66，95%CI = 0.46 - 0.94；Z =
