基于循证的术前肺康复对肺癌手术患者预后影响的meta分析

doi:10.3760/cma.j.cn441417-20241230-13009

摘要/Abstract

摘要：

目的　系统评价术前肺康复对肺癌手术患者术后并发症、病死率及住院时间的影响，为术前肺康复的应用提供循证医学证据。方法　检索PubMed、Cochrane、EMBASE、PEDro、中国知网、万方、维普等数据库，获取截止到2024年5月关于术前肺康复对肺癌患者术后影响的随机对照试验。对符合纳入标准的研究进行数据提取，使用STATA软件进行meta分析。结果　最终纳入16项随机对照试验，共涉及1 176例患者。meta分析结果显示，术前肺康复降低肺癌手术患者术后并发症发生率（OR=0.35，95%CI：0.26～0.46，P<0.001），缩短患者住院时间（WMD=-2.16，95%CI：-2.91～-1.41，P<0.001），但对患者术后病死率无显著影响（OR=0.37，95%CI：0.09～1.49，P=0.162）。结论　术前肺康复能够减少肺癌患者的术后并发症，缩短患者住院时间。未来应进一步探索最佳术前肺康复训练方案，并通过大样本、高质量的随机对照试验验证其有效性。

关键词: 肺癌, 肺康复, 术后并发症, 病死率, 住院时间, meta分析

Abstract:

Objective　To systematically evaluate the effects of preoperative pulmonary rehabilitation on postoperative complications, mortality, and hospital stay in patients undergoing lung cancer surgery, providing evidence-based supports for the application of preoperative pulmonary rehabilitation in lung cancer patients. Methods　A comprehensive search was conducted in databases including PubMed, Cochrane, EMBASE, PEDro, CNKI, Wanfang, and VIP to retrieve randomized controlled trials (RCTs) on the effect of preoperative pulmonary rehabilitation on lung cancer patients up to May 2024. Data extraction was performed on studies that met the inclusion criteria, and meta-analysis was performed using STATA software. Results　A total of 16 RCTs involving 1 176 patients were included. Meta-analysis results showed that preoperative pulmonary rehabilitation reduced the incidence of postoperative complications in patients undergoing lung cancer surgery (OR=0.35, 95%CI: 0.26 to 0.46, P<0.001), and shortened the hospital stay (WMD=-2.16, 95%CI: -2.91 to -1.41, P<0.001), but had no significant effect on the postoperative mortality rate (OR=0.37, 95%CI: 0.09 to 1.49, P=0.162). Conclusions　Preoperative pulmonary rehabilitation can significantly reduce the postoperative complications and shorten the hospital stay in lung cancer patients. Future research should explore the optimal preoperative pulmonary rehabilitation regimen and verify its efficacy through large-scale, high-quality RCTs.

Key words: Lung cancer, , Pulmonary rehabilitation, , Postoperative complications, , Mortality, , Hospital , stay, , Meta-analysis

吕晓东高呈飞于冬怡.

基于循证的术前肺康复对肺癌手术患者预后影响的meta分析 [J]. 国际医药卫生导报, 2025, 31(13): 2154-2160.

Lyu Xiaodong, Gao Chengfei, Yu Dongyi.

Effect of evidence-based preoperative pulmonary rehabilitation on the prognosis in patients undergoing lung cancer surgery: a meta analysis [J]. International Medicine and Health Guidance News, 2025, 31(13): 2154-2160.

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