非小细胞肺癌患者围术期运动最佳证据总结

doi:10.12114/j.issn.1007-9572.2021.01.005

摘要/Abstract

摘要： 背景　围术期运动能够有效改善非小细胞肺癌患者健康结局，但国内外众多的运动干预方案存在差异，尚无围术期运动最佳证据总结。目的　检索、评价和总结非小细胞肺癌患者围术期运动相关证据。方法　计算机检索Up To Date、BMJ Best Practice、乔安娜布里格斯研究所、循证卫生保健中心数据库、中国临床指南文库、美国国立临床诊疗指南数据库、The Cochrane Library、PubMed、中国知网等数据库关于非小细胞肺癌患者围术期运动方面的相关证据，包括证据总结、指南、专家共识、系统评价等，检索时间从建库至2020年7月。由接受过循证医学系统培训的研究者对其进行质量评价和证据级别评定。结果　共纳入22篇文献，包括证据总结1篇、指南3篇、专家共识1篇、系统评价14篇、随机对照试验3篇；纳入文献总体质量较高；从运动的必要性、运动人群、运动前评估、术前运动方案、术后运动方案、注意事项、效果评价7个方面汇总了22条最佳证据。结论　本研究总结了非小细胞肺癌患者围术期运动的最佳证据，提示临床医护人员应重视运动管理，全面评估患者，并结合患者的偏好，围绕运动人群、运动前评估、术前运动方案、术后运动方案、注意事项、效果评价等内容制定个体化运动方案。

关键词: 癌, 非小细胞肺；运动疗法；围手术期；循证医学

Abstract: Background　Appropriate perioperative exercise can effectively improve the health outcome of non-small cell lung cancer （NSCLC） patients，but the related best evidence about the effectiveness of various intervention programs has not been summarized. Objective　To search and evaluate studies about perioperative exercise improving the health outcome of NSCLC patients，then summarize the best evidence. Methods　We searched Up To Date，BMJ Best Practice，Joanna Briggs Institute Evidence-Based Practice Database，China National Guideline Clearinghouse，National Guideline Clearinghouse，The Cochrane Library，PubMed，CNKI and other databases to collect evidence summaries，guidelines，expert consensuses and systematic reviews regarding perioperative exercise improving the health outcome in patients with NSCLC from inception to July 2020. Methodological quality and evidence level were assessed by researchers systematically trained on evidence-based medicine. Results　Totally 22 studies were included，including 1 evidence summary，3 guidelines，1 expert consensus，14 systematic reviews and 3 randomized controlled trials. Their methodological qualities were rated high overall. Finally 22 pieces of best evidence involving 7 dimensions were summarized，namely，necessity of perioperative exercise，population suitable for performing perioperative exercise，pre-exercise health evaluation，preoperative exercise program，postoperative exercise program，precautions and effectiveness evaluation. Conclusion　This summary indicates that clinical healthcare workers should value the exercise management for NSCLC patients，and develop personalized intervention programs（including preoperative and postoperative exercise programs） with the patient's individual features〔such as comprehensive health evaluation（including per-exercise evaluation） and preference〕，precautions and effectiveness evaluation regarding the exercise taken into account.

Key words: Carcinoma, non-small-cell lung；Exercise therapy；Perioperative period；Evidence-based medicine

王婷婷,章新琼,王爱梅,等. 非小细胞肺癌患者围术期运动最佳证据总结[J]. 中国全科医学, 2021, 24(29): 3671-3677. DOI: 10.12114/j.issn.1007-9572.2021.01.005.
WANG Tingting,ZHANG Xinqiong,WANG Aimei, et al. Summary of the Best Evidence Regarding Perioperative Exercise Improving the Health Outcome in Patients with Non-small Cell Lung Cancer　[J]. Chinese General Practice, 2021, 24(29): 3671-3677. DOI: 10.12114/j.issn.1007-9572.2021.01.005.

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