目的 系统分析肺康复在脑卒中相关性肺炎(stroke-associated pneumonia,SAP)患者中的应用研究,以期为临床医护人员开展相关干预提供参考.方法 系统检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方、维普和中国生物医学数据库,检索时限自建库至2023年12月31日.采用范围综述的方法对纳入研究进行分析.结果 共纳入16篇研究,主要为随机对照试验和类实验研究.研究主要集中在中国和韩国;样本量一般为40～80例;干预持续时间大多为2～4周;涉及6种不同的肺康复干预措施.主要结局指标包括肺功能、SAP发生率、死亡率、认知功能、脑卒中严重程度、入住重症监护病房时长、抗菌药物使用时长及日常生活活动能力等临床结局指标.纳入研究大多显示,肺康复对SAP患者影响显著.结论 肺康复在SAP患者中应用的有效性已经获得初步验证.未来研究需要覆盖更广泛的地区和更大的样本量,并进行长期跟踪研究和多维度评价,以增强结果的普适性和可靠性.
Application of pulmonary rehabilitation in patients with stroke-associated pneumonia:a scoping review
Objective To systematically analyse the application of pulmonary rehabilitation in patients with stroke-associated pneumonia(SAP),in order to provide reference for clinical healthcare professionals to carry out relevant interventions.Methods PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure,Wanfang,Chongqing VIP,and SinoMed were systematically searched,with a search period from database establishment until December 31,2023.The scoping review method was used to analyze the included studies.Results A total of 16 studies were included,mainly randomized controlled trials and quasi-experimental studies.The research mainly focuses on China and South Korea.The sample size was generally 40-80 cases.The duration of intervention is mostly 2-4 weeks.Six different lung rehabilitation interventions were involved.The main outcome measures included lung function,incidence of SAP,mortality rate,cognitive function,severity of stroke,length of intensive care unit stay,duration of antibiotic use,and daily living activity.Most studies had shown that lung rehabilitation has a significant impact on SAP patients.Conclusions The effectiveness of pulmonary rehabilitation in SAP patients has been preliminarily validated.Future research needs to cover a wider range of regions and larger samples,and conduct long-term tracking studies and multidimensional evaluations to enhance the universality and reliability of the results.
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