慢性心力衰竭患者有氧运动方案的最佳证据总结  

Summary of best evidence for aerobic exercise regimens in patients with chronic heart failure

作　　者：张晓曼 李振香[1] 张琦 赵宝生 王伟[4] Zhang Xiaoman;Li Zhenxiang;Zhang Qi;Zhao Baosheng;Wang Wei(Outpatient Department,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,China;School of Nursing,Shandong University of Traditional Chinese Medicine,Jinan 250355,China;School of Nursing,Shandong University,Jinan 250012,China;Department of Cardiology,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250012,China)

机构地区：[1]山东大学附属省立医院门诊部,济南250021 [2]山东中医药大学护理学院,济南250355 [3]山东大学护理学院,济南250012 [4]山东大学附属省立医院心内科,济南250021

出　　处：《中华现代护理杂志》2021年第7期851-857,共7页Chinese Journal of Modern Nursing

基　　金：山东省重点研发计划项目(2016GSF201224)。

摘　　要：目的:检索并获取慢性心力衰竭(CHF)患者有氧运动的最佳证据,为临床制订科学、规范的CHF患者有氧运动方案提供依据。方法:检索BMJ Best Practice、Joanna Briggs Institute循证卫生保健中心数据库、国际指南协作网、UpToDate、美国指南网、英国国家临床医学研究所指南库、苏格兰学院间指南网、CINAHL、Embase、Cochrane Library、中国指南网、PubMed、中国生物医学文献数据库、WHO及心内科专业网站中有关CHF患者有氧运动的所有证据。检索时限为建库至2020年5月31日。结果:共纳入文献14篇,包括6篇指南,1篇专家共识和7篇系统评价。最终共总结有氧运动的必要性、有氧运动前准备、有氧运动的四要素、有氧运动模式4个方面的17条最佳证据。结论:有氧运动对射血分数下降的心力衰竭患者而言是安全有效的;运动强度的设定应基于症状限制性心肺运动试验结果;>6个月的运动对CHF患者有效;间歇有氧训练辅助抗阻运动能够改善患者峰值摄氧量,提高患者的心肺适应性、肌肉力量,改善心功能和提高生活质量,应被视为稳定期CHF患者运动锻炼的重要方式。Objective To search and obtain the best evidence of aerobic exercise for patients with chronic heart failure(CHF)to provide a basis for clinically formulating scientific and standardized aerobic exercise programs for CHF patients.Methods BMJ Best Practice,Joanna Briggs Institute(JBI)Evidence-Based Health Care Center Database,Guideline International Network(GIN),UpToDate,National Guideline Clearinghouse(NGC),National Institute for Health and Clinical Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),CINAHL,Embase,Cochrane Library,Chinese Guidelines Network,PubMed,China Biomedical Literature Database(CBM),WHO and cardiology professional websites were searched to collect all evidence for aerobic exercise for CHF patients.The search time limit was from the establishment of the database to May 31,2020.Results A total of 14 articles were included,including 6 guidelines,1 expert consensus and 7 systematic reviews.Finally,a total of 17 best evidence for 4 aspects including the necessity of aerobic exercise,preparation before aerobic exercise,4 elements of aerobic exercise and the mode of aerobic exercise were summarized.Conclusions Aerobic exercise is safe and effective for patients with heart failure with decreased ejection fraction.The setting of exercise intensity should be based on the results of a symptom-restricted cardiopulmonary exercise test.Exercise for more than 6 months is effective for CHF patients.Intermittent aerobic training assisted resistance exercise can improve peak oxygen uptake,cardiorespiratory fitness and muscle strength of patients,so as to improve cardiac function and quality of life,which should be regarded as an important way of exercise for patients with stable CHF.

关 键 词：心力衰竭 有氧运动 最佳证据 

分 类 号：R541.6[医药卫生—心血管疾病]