摘要
目的 系统评价经桡动脉行冠状动脉介入术患者术后早期下床活动的效果.方法 检索1993年1月1日至2023年12月31日发表在Cochrane Library、PubMed、Web of Science、Embase、中国知网、中国生物医学文献数据库、维普资讯网、万方数据库和国内外临床试验注册中心有关经桡动脉行冠状动脉介入术后早期下床活动的试验性研究,对纳入研究进行质量评价,采用RevMan 5.3软件进行Meta分析.结果 最终纳入12项研究,Meta分析结果显示,与常规康复相比,经桡动脉行冠状动脉介入术后早期下床活动有利于改善患者左室射血分数[MD=4.35,95％CI(1.96,6.74),P＜0.01];能提高患者生活质量[SMD=2.56,95％CI(1.37,3.75),P＜0.01];增强患者日常生活能力[MD=3.78,95％CI(1.87,5.69),P＜0.01];降低心绞痛[OR=0.35,95％CI(0.16,0.79),P=0.01]、心律失常[OR=0.33,95％CI(0.15,0.70),P＜0.01]和心力衰竭[OR=0.35,95％CI(0.13,0.91),P=0.03]发生率;对改善冠状动脉再狭窄[OR=0.28,95％CI(0.07,1.16),P=0.08],左室舒张末内径[MD=-1.53,95％CI(-4.58,1.53),P=0.33]和 6 分钟步行距离[MD=32.87,95％CI(-2.03,67.77),P=0.06]效果不显著.结论 早期下床活动可以明显改善经桡动脉行冠状动脉介入术后患者的心功能,提高其生活质量和日常生活能力,减少并发症,促进患者的康复.
Abstract
Objective To evaluate the effects of early ambulation after percutaneous coronary intervention(PCI).Methods The experimental studies about early ambulation after PCI were searched in the Cochrane Library,PubMed,Web of Science,Embase,CNKI,CBM,VIP,and Wanfang Data,as well as domestic and foreign clinical trial register centers with the time setting between January 1,1993 and December 31,2023.After literature screening,data extraction and bias risk assessment,Meta-analysis was performed by using the RevMan 5.3 software.Results A total of 12 studies were included.Meta-analysis showed that compared with conventional rehabilitation,early ambulation after PCI helped improve the left ventricular ejection fraction[MD=4.35,95％CI(1.96,6.74),P＜0.01],life quality[SMD=2.56,95％CI(1.37,3.75),P＜0.01]and activities of daily life[MD=3.78,95％CI(1.87,5.69),P＜0.01],and lower the incidence of angina pectoris[OR=0.35,95％CI(0.16,0.79),P=0.01],arrhythmia[OR=0.33,95％CI(0.15,0.70),P＜0.01]and heart failure[OR=0.35,95％CI(0.13,0.91),P=0.03].However,no significant improvement was observed in improving coronary restenosis[OR=0.28,95％CI(0.07,1.16),P=0.08],the left ventricular end-diastolic dimension[MD=-1.53,95％CI(-4.58,1.53),P=0.33]and six minute walk distance[MD=32.87,95％CI(-2.03,67.77),P=0.06].Conclusion Early ambulation after percutaneous coronary intervention can significantly improve the heart function,life quality and activities of daily life,but reduce complications,promoting the recovery of patients.
基金项目
甘肃省卫生健康行业科研资助项目(GSWSHL2020-15)
甘肃中医药大学附属医院科研及技术创新基金项目(gzfy-2021-22)
NETL
NSTL
万方数据