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神经肌肉电刺激在胸部和腹部手术中的有效性:系统性审查和元分析

Yuki Nakashima^1,2, Daisuke Iwaki^1,3, Yuki Kataoka^2,4,5,6

¹Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.

|November 30, 2023

概括

神经肌肉电刺激 (NMES) 可能在心血管手术后稍微改善下肢肌肉的强度. 虽然通常是安全的,但对于胸部和腹部手术患者需要更多高质量的试验.

科学领域:

医疗康复医疗康复
术后恢复术后恢复
临床试验临床试验

背景情况:

手术后恢复,特别是在胸部和腹部手术后,通常涉及肌肉疲软和生活质量下降.
神经肌肉电刺激 (NMES) 是缓解这些缺陷的潜在干预措施.

研究的目的:

系统地审查和元分析NMES在下肢肌肉强度和与健康相关的生活质量 (HR-QOL) 的疗效,胸部和腹部手术后.
评估该患者群体中与NMES相关的安全性和不良事件.

主要方法:

通过全面的数据库搜索 (Cochrane,MEDLINE,EMBASE,PEDro,CINAHL,WHO ICTRP,ClinicalTrials.gov) 确定的随机对照试验 (RCT) 的系统审查和元分析.
纳入标准集中在评估NMES对下肢肌肉强度的影响的RCT,HR-QOL,以及胸部和腹部手术后的不良事件.
偏差风险和建议评级,评估,开发和评估 (GRADE) 工具被用于证据评估.

主要成果:

包括18个RCT与915名参与者,涵盖心血管,肺和消化器官手术.
在心血管手术后,NMES显示下肢肌肉强度略有增加.
七名患者报告了不良事件,包括低血压,疼痛和肌肉不适,但不被认为是严重的.

结论:

在心血管外科手术后,NMES对下肢肌肉强度有适度的益处,严重不良事件的风险较低.
关于NMES对HR-QOL的影响的证据由于异质性而有限.
需要更高质量的RCT来确定NMES在更广泛的胸部和腹部外科患者群体中的最终疗效和安全性.

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