经过重大腹部手术的患者的身体预康复:使用GRADE和CINeMA方法进行全面的系统审查和组件网络元分析
Claudio Ricci1,2, Laura Alberici3, Francesco Serbassi4
1Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, via Albertoni 15, Bologna, Italy. claudio.ricci6@unibo.it.
Annals of surgical oncology
|December 1, 2023
概括
身体预康复,结合有氧运动 (AE) 和启发性肌肉训练 (IMT),显著降低了主要腹部手术后的发病率和停留时间. 这种综合方法为患者的康复提供了最实质性的好处.
科学领域:
- 外科手术的结果
- 康复医学 康复医学 康复医学
- 基于证据的实践.
背景情况:
- 对于接受重大腹部手术的患者,建议进行身体预康复.
- 前期康复旨在改善短期结果并减少并发症.
研究的目的:
- 为了确定进行重大腹部手术的患者最有效的手术前体力活动类型.
- 为了比较有氧运动 (AE),启发性肌肉训练 (IMT) 和抵抗训练的益处.
主要方法:
- 对25项研究进行了一项频率主义的随机效应网络元分析 (NMA).
- 分析的结果包括整体发病率,主要发病率,死亡率,停留时间 (LOS) 和肺炎.
- 用组件网络方法进行分析,报告几率比率 (OR) 和平均差异 (MD) 以95%的置信区间 (CI).
主要成果:
- 有氧运动 (AE) 和AE + IMT在降低整体发病率方面最有效.
- AE + IMT在降低肺炎率方面显示出最大的益处 (OR = 0.21).
- AE + IMT的组合导致逗留时间缩短时间最长 (MD = -1.70天).
结论:
- 身体预康复有效地减少了在接受重大腹部手术的患者的整体发病率,肺炎发病率和停留时间.
- 同时使用有氧运动 (AE) 和启发性肌肉训练 (IMT) 产生了最显著的积极效果.
- 建议采用这种联合预康复策略,以优化患者的康复.
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