术前运动训练对肺癌患者干预效果的系统评价再评价 [中文引用][英文引用]

目的  对肺癌患者术前运动训练干预效果系统评价进行再评价。方法  采用计算机检索 PubMed，EMbase，Cochrane Library，Web of Science，CINAHL，澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库（Joanna Briggs Institute ofAustralia’s Centre for Evidence-based Health Care Database，JBI），CNKI，万方，维普和 SinoMed 中关于术前运动训练对肺癌患者干预效果的系统评价 /Meta分析，检索时限为建库至 2024年 1月 10日。由 2名经过培训的研究者独立进行文献筛选、数据提取，并对纳入文献进行方法学质量评价，对证据进行汇总与分级。结果  共纳入 8 篇系统评价。系统评价方法学质量评价工具 2（assessment of multiple system reviews 2，AMSTAR 2）结果显示 1 篇质量等级为中，4 篇为低，3 篇为极低；系统综述和荟萃分析优先报告的条目（preferred reporting items for systematic reviews and Meta-analyses，PRISMA）结果显示 3 篇报告质量相对全面，4 篇有一定的缺陷，1 篇有相对严重的信息缺陷；汇总并分级为 7 类共 56 个结局指标，其中 9 个为中级，29 个为低级，18 个为极低级。重新 Meta 分析结果显示，术前运动训练能够提升肺癌患者术前心肺功能，降低肺癌术后肺部并发症（postoperative pulmonarycomplications，PPCs）发生的风险，缩短住院时间。结论  术前运动训练有利于改善患者临床结局，但目前研究方法学质量、报告规范及证据质量有待提高，未来需开展设计更严谨、高质量的研究，并增加不同运动方式和运动周期的对比，为构建高效、合理周期的术前运动训练方案提供参考。

Objective To re-evaluate the systematic evaluation of effectiveness of preoperative exercise intervention in patients with lung cancer. Methods Literature in systematic reviews and meta-analyses of the effectiveness of preoperative exercise intervention among patients with lung cancer was retrieved from databases of PubMed，EMbase，Cochrane Library，Web of Science，CINAHL， Joanna Briggs Institute of Australia’s Centre for Evidence-based Health Care Database（JBI），China National Knowledge Infrastructure （CNKI），Wanfang Data，VIP，and SinoMed from the inception to January 10，2024. Two reviewers independently screened the retrieved literature，extracted data，evaluated methodological quality，and summarised and graded the evidence. Results Eight systematic reviews were included. Methodological quality was rated moderate for one review，low for four，and very low for three. Preferred reporting items for systematic reviews and Meta-analyses was found comprehensive in three reviews，incomplete in four and seriously deficient in one. Seven outcome categories comprising 56 indicators were summarised and graded：nine indicators were of moderate certainty， 29 of low certainty，and 18 of very low certainty. Pooled evidence from re-meta-analysis showed that preoperative exercises improved preoperative cardiopulmonary function，reduced the risk of post-operative pulmonary complications（PPCs），and shortened a hospital stay. Conclusion Preoperative exercise can improve patient outcomes after surgery. However，current studies often face methodological limitations，inadequate reporting standards and low-quality evidence. Future research should employ more rigorous designs and higherquality evidence，including comparisons of different exercise modalities and durations，and provide a basis for developing efficient and optimally timed pre-operative exercise protocols.