早期床上脚踏车运动在ICU机械通气病人中应用效果的Meta分析  

Application effect of early in⁃bed cycling exercise in mechanically ventilated ICU patients:a Meta⁃analysis

作　　者：王瑞[1] 魏花萍[2] 孔佳佳 程洁 丁楠楠 张志刚[1,2] WANG Rui;WEI Huaping;KONG Jiajia;CHENG Jie;DING Nannan;ZHANG Zhigang(School of Nursing,Lanzhou University,Gansu 730000 China)

机构地区：[1]兰州大学护理学院,甘肃730000 [2]兰州大学第一医院

出　　处：《护理研究》2021年第16期2825-2832,共8页Chinese Nursing Research

基　　金：甘肃省科技计划项目,编号:20YF2FA032;兰州大学护理学院科研项目,编号:LZUSON202004。

摘　　要：目的:评价早期床上脚踏车运动在重症监护病房(ICU)机械通气病人中的应用效果。方法:计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CINAHL、中国知网(CNKI)、万方数据库(Wanfang Data)、中国生物医学文献数据库(CBM)、维普(VIP)数据库中有关ICU机械通气病人进行床上脚踏车运动的随机对照试验(RCT)。检索时限为建库至2020年10月31日,2名研究者独立根据Cochrane系统评价方法对纳入文献进行质量评价和资料提取,对符合纳入标准的文献采用RevMan 5.3软件进行Meta分析。结果:共纳入9篇RCT,中文5篇,英文4篇。Meta分析结果显示:与常规物理治疗比较,早期床上脚踏车运动更有益于降低ICU获得性衰弱(ICU‐AW)发生率[OR=0.30,95%CI(0.14,0.65),P=0.002],缩短机械通气时间[MD=-1.28,95%CI(-2.08,-0.48),P=0.002],减少ICU住院时间[MD=-1.59,95%CI(-2.23,-0.95),P<0.00001],合并效应有统计学意义。结论:现有证据表明,ICU机械通气病人进行早期床上脚踏车运动可以有效降低ICU‐AW发病率,缩短机械通气时间及ICU住院时间。Objective:To evaluate the effect of early in‐bed cycling exercise on mechanically ventilated patients in the Intensive Care Unit(ICU).Methods:The randomized clinical trials(RCTs)related to applying in‐bed cycling exercise in mechanically ventilated ICU patients were retrieved from PubMed,EMbase,The Cochrane Library,Web of Science,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,China Biomedical Literature Database(CBM),and V IP Database from the establishment of the database to October 31,2020.According to the Cochrane system,two researchers evaluated and extracted data and analyzed the results using RevMan 5.3 software.Results:A total of 9 RCTs were included in this study,involving 5 Chinese articles and 4 English articles.The meta‐analysis results showed that compared with physical therapy,early in‐bed cycling exercise was more beneficial to reduce the incidence of ICU‐acquired weakness(ICU‐AW)[OR=0.30,95%CI(0.14,0.65),P=0.002],shorten ventilation time[MD=-1.28,95%CI(-2.08,-0.48),P=0.002],and reduce the length of stay(LOS)in ICU[MD=-1.59,95%CI(-2.23,-0.95),P<0.00001].The combined effect was statistically significant.Conclusions:The evidence showed that early in‐bed cycling exercise could reduce ICU‐AW incidence,shorten the mechanical ventilation time and the LOS in ICU of mechanically ventilated patients.

关 键 词：重症监护 机械通气 脚踏车运动 ICU获得性衰弱 住院时间 META分析 循证护理 

分 类 号：R472.2[医药卫生—急诊医学]