心脏康复对冠状动脉旁路移植术患者生活质量影响的系统评价

doi:10.3760/cma.j.issn.1007-1245.2022.10.030

摘要/Abstract

摘要： 目的　系统评价心脏康复（CR）对冠状动脉旁路移植术（CABG）患者生活质量的影响。方法　检索PubMed、Web of Science、EMBASE、Medline、The Cochrane Library、中国知网、万方、维普中文科技期刊数据库、中国生物医学文献服务系统数据库和医脉通、梅斯医学、中国临床指南文库网站等一些其他资源，检索参与CR与常规护理对CABG后患者生活质量影响的随机对照试验（RCT），检索时间均为建库至2021年5月。使用RevMan 5.4软件进行分析。结果　共纳入10篇RCT，共773例患者，其中CR组383例，常规治疗组390例。meta分析结果显示：CR组与常规治疗组相比，在生理功能（MD=11.85，95%CI 5.25～18.45，P=0.000 4）、生理职能（MD=6.96，95%CI 4.94～8.97，P<0.000 01）、躯体疼痛（MD=6.74，95%CI 2.39～11.10，P=0.002）、总体健康（MD=12.22，95%CI 7.35～17.10，P<0.000 01）、活力（MD=14.45，95%CI 6.92～21.79，P=0.000 2）、社会功能（MD=7.11，95%CI 2.83～11.39，P=0.001）、情感职能（MD=9.70，95%CI 2.64～16.76，P=0.007）、精神健康（MD=11.10，95%CI 4.61～17.58，P=0.000 8）方面均有改善，但在生理健康（MD=9.29，95%CI -8.74～27.32，P=0.31）和心理健康（MD=8.51，95%CI -12.26～29.29，P=0.42）方面比较差异均无统计学意义。结论　对于行CABG患者，术后进行CR训练可以在一定程度上提高患者的生活质量，但在生理健康和心理健康方面无明显改善，考虑本研究纳入的部分文献异质性较大，需通过开展高质量、大样本、多中心的RCT予以验证。

关键词: 冠状动脉旁路移植术, 心脏康复, 生活质量, meta分析

Abstract: Objective　To systematically evaluate the effect of cardiac rehabilitation (CR) on the quality of life in patients undergoing coronary artery bypass grafting (CABG). Methods　Databases, including PubMed, Web of Science, EMBASE, Medline, The Cochrane Library, CNKI, Wanfang Data, VIP, and SinoMed, and some other resources such as Yimaitong, Metz Medicine, and China Clinical Guidelines Library website were searched to collect the randomized controlled trials (RCTs) involving CR and routine care on the quality of life in patients after CABG from the establishment of database to May 2021. The data were analyzed by the RevMan 5.4 statistical software. Results　A total of 10 RCTs were included, with a total of 773 patients, including 383 cases in the CR group and 390 cases in the conventional treatment group. The meta analysis results showed that compared with the conventional treatment group, the CR group improved in terms of physiological function (MD=11.85, 95%CI 5.25-18.45, P=0.000 4), physiological function (MD=6.96, 95%CI 4.94-8.97, P<0.000 1), somatic pain (MD=6.74, 95%CI 2.39-11.10,P=0.002), general health (MD=12.22, 95%CI 7.35-17.10, P<0.000 01), vitality (MD=14.45, 95%CI 6.92-21.79, P=0.002), social function (MD=7.11, 95%CI 2.83-11.39,P=0.001), emotional function (MD=9.70, 95%CI 2.64-16.76, P=0.007), and mental health (MD=11.10，95%CI 4.61-17.58，P=0.000 8), but were not statistically significantly different in terms of physical health (MD=9.29, 95%CI -8.74-27.32, P=0.31) and mental health (MD=8.51, 95%CI -12.26-29.29, P=0.42). Conclusions　For patients undergoing CABG, postoperative CR training can improve their quality of life to a certain extent, but there is no significant improvement in physical health or mental health. Considering the large heterogeneity of some literatures included in this study, it needs to be verified by conducting high-quality, large-sample, and multi-center RCTs.

Key words: Coronary artery bypass grafting, Cardiac rehabilitation, Quality of life, Meta analysis

袁丽娟, 向圣晓, 袁甜甜, 郝海琴, 谢萍. 心脏康复对冠状动脉旁路移植术患者生活质量影响的系统评价[J]. 国际医药卫生导报, 2022, 28(10): 1448-1457.

Yuan Lijuan, Xiang Shengxiao, Yuan Tiantian, Hao Haiqin, Xie Ping. Systematic review on the effect of cardiac rehabilitation on the quality of life in patients undergoing coronary artery bypass grafting[J]. International Medicine and Health Guidance News, 2022, 28(10): 1448-1457.

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