远程心脏康复对慢性心力衰竭患者影响的Meta分析
Effects of remote cardiac rehabilitation on the patients with chronic heart failure:a Meta-analysis
程钰 1李朝凤 2丁华 3严静 3顾怡沁3
作者信息
- 1. 南京中医药大学 护理学院,江苏 南京 210023;南京中医药大学附属南京医院/南京市第二医院 心血管内科,江苏 南京 210003
- 2. 南京中医药大学附属南京医院/南京市第二医院 心血管内科,江苏 南京 210003
- 3. 南京中医药大学 护理学院,江苏 南京 210023
- 折叠
摘要
目的:系统评价远程心脏康复(CR)对慢性心力衰竭(CHF)患者的影响.方法:计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网(CNKI)、中国生物医学文献数据库、万方数据知识服务平台、维普中文科技期刊数据库(VIP),收集远程CR应用于CHF患者的随机对照试验相关文献,检索时限为建库至2022 年4 月.对符合纳入、排除标准的文献进行质量评价,使用RevMan 5.3 软件对提取数据进行Meta分析.结果:最终纳入20 篇文献,共2 670 例患者.Meta分析结果显示,与传统康复护理相比,远程CR能有效地提高CHF患者心肺功能(MD =31.58,95%CI:10.5～52.67,P =0.003)、运动功能(MD =38.59,95%CI:22.73～54.46,P<0.05)、VO2峰值(MD =2.72,95%CI:0.62～4.82,P =0.01)、生活质量(MD =-10.24,95%CI:-13.51～-6.97,P<0.000 1)、CR依从性(RR =2.51,95%CI:1.58～3.99,P<0.000 1);在缓解焦虑(MD =-0.30,95%CI:-0.61～0.02,P>0.05)和抑郁方面(MD =-0.19,95%CI:-0.52～0.15,P>0.05)两者差异无统计学意义.结论:远程CR与传统康复护理相比,能有效地改善CHF患者的心肺功能和运动能力,提升其生活质量和CR依从性,但在改善心理健康方面缺乏证据支持.需要进一步的研究验证远程CR对CHF患者的有效性、安全性和成本效益.
Abstract
Objective:To systematically evaluate the effect of remote cardiac rehabilitation(CR)on patients with chronic heart failure(CHF).Methods:Computerized search of PubMed,Web of Science,Cochrane Library,Embase,CNKI,China biomedical literature database,Wanfang and VIP were performed to collect randomized controlled trials of remote CR applied to CHF patients,with a search timeframe of the period from inception to April 2022.Literatures that met the inclusion and exclusion criteria were evaluated for quality,and Meta-analysis of the extracted data were performed using RevMan 5.3 software.Results:A total of 20 studies with 2 670 patients were included.The results of the Meta-analysis showed that compared with traditional rehabilitation care,remote CR can effectively improve the cardiopulmonary function(MD = 31.58,95%CI:10.5-52.67,P = 0.003),motor function(MD =38.59,95%CI:22.73-54.46,P<0.05),peak VO2(MD =2.72,95%CI:0.62-4.82,P = 0.01),quality of life(MD =-10.24,95%CI:-13.51--6.97,P<0.000 1),and adherence CR compliance(RR =2.51,95%CI:1.58-3.99,P<0.000 1)of CHF patients.There was no statistically significant difference in relieving anxiety(MD =-0.30,95%CI:-0.61-0.02,P>0.05)and depression(MD =-0.19,95%CI:-0.52-0.15,P>0.05).Conclusion:Remote CR is effective in improving cardiopulmonary function and motor function,quality of life and CR compliance in patients with CHF compared with traditional rehabilitation care,but there is a lack of evidence to support the improvement in mental health.Further studies are needed to validate the effectiveness,safety,and cost-effectiveness of remote CR for CHF patients.
关键词
远程康复/心脏康复/慢性心力衰竭/Meta分析Key words
telerehabilitation/cardiac rehabilitation/chronic heart failure/Meta-analysis引用本文复制引用
基金项目
南京市医学科技发展项目(YKK21122)
出版年
2024
NETL
NSTL
维普
万方数据