术前呼吸肌锻炼对腹部手术患者术后肺部并发症影响的Meta分析

摘要

Objective To evaluate the effect of preoperative respiratory muscle exercise on the prevention of postoperative pulmonary complications in patients with abdominal operation. Methods The published randomized control trails ( RCT ) on preoperative respiratory muscle exercise for the prevention of pulmonary complications after abdominal operation were collected in the databases of PubMed, the Cochrane Library, Chinese BioMedical Literature Database ( CBM) by computer from January 1, 1975 to March 1, 2016. Two researchers extracted the data and assessed the quality of studies according to the revised edition of Jadad scale independently. Then meta-analyses were performed on included studies. Results A total of 6 RCTs involving 385 patients were included. The results of meta-analyses showed that the preoperative respiratory muscle exercise could effectively decrease the incidence of pulmonary infection [ OR=0. 38, 95%CI ( 0. 16, 0. 91), P=0.03], pulmonary atelectasis [OR=0.17, 95%CI (0.05, 0.56), P=0.004].Conclusions The preoperative respiratory muscle exercise can effectively decrease the incidence of pulmonary infection and pulmonary atelectasis.%目的：评价术前呼吸肌锻炼对预防腹部手术患者术后肺部并发症的效果。方法计算机检索PubMed数据库、Cochrane Library 以及中国生物医学文献服务系统( CBM)1975年1月1日—2016年3月1日公开发表的关于术前呼吸肌锻炼预防腹部手术后肺部并发症的随机对照试验( RCT),由2名评价员独立提取并根据改良Jadad评分量表进行文献质量评价,对符合质量标准的研究进行Meta分析。结果共纳入6项RCT,385例患者。 Meta分析结果显示,术前呼吸肌锻炼能够有效减少肺部感染的发生率[OR＝0.38,95％CI(0.16,0.91),P＝0.03]；减少肺不张的发生率[OR＝0.17,95％CI(0.05,0.56), P＝0.004]。结论术前呼吸肌锻炼能够有效降低腹部手术患者术后肺部感染及肺不张的发生率。