Early pulmonary rehabilitation in acute exacerbation of chronic obstructive pulmonary disease:a systematic review
10.3969/j.issn.1008-9691.2024.06.007
- VernacularTitle:早期肺康复对慢性阻塞性肺疾病急性加重期患者干预效果的系统评价
- Author:
Jici NIU
1
;
Chenxi SHI
;
Yanrui JIA
Author Information
1. 首都医科大学护理学院,北京 100069
- Publication Type:Journal Article
- Keywords:
Chronic obstructive pulmonary disease;
Acute exacerbation of chronic obstructive pulmonary disease;
Pulmonary rehabilitation;
Evidence-based nursing
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(6):676-683
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effectiveness of early pulmonary rehabilitation for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)through systematic review.Methods Chinese biomedical literature database,China National Knowledge Infrastructure(CNKI),Wanfang database,VIP database,Cochrane Library,PubMed database of the National Library of Medicine,Web of Science(WOS),Ebsco,Scopus,Embase and Chinese Clinical Trial Registry database were searched for relevant literatures on the application of early pulmonary rehabilitation in patients with AECOPD published from the establishment of the database to August 2024.After literature screening,data extraction and literature quality evaluation by two researchers independently,Meta-analysis was used to evaluate the effects of early pulmonary rehabilitation on lung function,exercise capacity,symptom severity,quality of life and prognosis in patients with AECOPD,and the funnel plot was drawn.Results A total of 10 studies involving 1 155 patients were included.The results of meta-analysis showed that compared with the control group of pulmonary rehabilitation after the condition was stable,early pulmonary rehabilitation helped to improve the lung function level of AECOPD patients:forced expiratory volume in 1 second[FEV1,mean difference(MD)=0.12,95%confidence interval(95%CI)was 0.07-0.17,P<0.00001],FEV1 as a percentage of predicted value(FEV1%,MD=6.11,95%CIwas 1.85-10.38,P=0.005),FEV1/forced vital capacity(FVC)ratio(MD=7.99,95%CI was 4.88-11.11,P<0.000 01).Early pulmonary rehabilitation significantly improved exercise capacity as measured by 6-minute walk distance(6MWD,MD=26.62,95%CI was 12.87-40.37,P=0.0001),and reduced both mMRC dyspnea scale(MD=-0.41,95%CI was-0.60 to-0.23,P<0.000 1)and COPD assessment test(CAT)scores(MD=-1.73,95%CI was-2.73 to-0.73,P=0.000 7).However,the mortality rate was significantly increased[odds ratio(OR)=1.65,95%CI was 1.06-2.57,P=0.03].The funnel plot was drawn for the total effective rate(FEV1 in the early pulmonary rehabilitation group compared with the control group)with the largest number of included literatures,and the results showed that the funnel plot was roughly symmetrical distribution,suggesting that there was less possibility of publication bias.Conclusion Early pulmonary rehabilitation with training can improve the lung and motor function,the quality of life while relieving symptoms in AECOPD patients.
