目的 系统评价预康复对肺癌合并慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）手术患者的临床应用效果，为今后预康复广泛应用于肺癌合并COPD患者提供有效证据。方法 检索Cochrane Library、PubMed、Embase、Web of Science、CINAHL、中国知网、万方、维普和中国生物医学文献服务系统等数据库中收录的肺癌合并COPD患者预康复的相关文献，检索时限为建库至2022年6月。由两名人员独立进行筛选、评价文献及提取信息，并用 Rev Man 5.4 软件进行整合分析。结果 纳入14篇文献，共942例患者。Meta分析显示，预康复组的患者术后肺功能水平第1秒用力呼气容积（forced expiratory volume in first second,FEV₁）[MD=0.22,95%CI(0.07,0.37)]、用力肺活量（forced vital capacity,FVC）[MD=0.17,95%CI (0.06,0.29)]、6分钟步行试验（6 minutes walk test,6MWT）[MD=53.54,95%CI(44.28,62.79)]水平明显优于常规护理组，机械通气时间[MD=-8.66,95%CI(-9.86,-7.47)]缩短，术后肺部并发症（postoperative pulmonary complications,PPCs）的发生率更低[RR=0.45,95%CI(0.33,0.60)]，术后住院时间明显缩短[MD=-2.01,95%CI(-2.43,-1.60)]（均P＜0.05）。结论 术前肺康复训练可以改善肺癌合并COPD患者的肺功能及活动耐力，减少PPCs和术后住院时间，有利于术后肺的功能恢复及改善生活质量。

Objective To systematically evaluate the clinical effectiveness of prehabilitation on lung cancer patients with chronic obstructive pulmonary disease (COPD) and to provide effective evidence for its wider application in the future.Methods Cochrane Library,PubMed,Embase,Web of Science,CINAHL,CNKI,Wanfang, VIP and SinoMed were searched to retrieve literature on prehabilitation of lung cancer patients with COPD.The retrieval time frame was from inception to June,2022.Two independent reviewers screened,evaluated and extracted information from the retrieved literature.Rev Man 5.4 were used for meta-analysis.Results A total of 14 articles and 942 patients were included.Meta-analysis results showed that patients in the prehabilitation group had significantly better lung function levels of FEV₁[MD=0.22,95%CI(0.07,0.37)],FVC[MD=0.17,95%CI(0.06,0.29)] and 6 minute walking test[MD=53.54,95%CI(44.28,62.79)] than the routine care group.The mechanical ventilation time [MD=-8.66,95%CI(-9.86,-7.47)] was shortened.Postoperative complications [RR=0.45,95%CI(0.33,0.60)] were less frequent.Postoperative hospital stay[MD=-2.01,95%CI(-2.43,-1.60)] was significantly shorter (all P＜0.05).Conclusions Prehabilitation can improve lung function and activity endurance of lung cancer patients with COPD,reduce PPCs and shorten postoperative hospital stay.It facilitates functional recovery and improves quality of life after surgeries.

R473.56

上海市抗癌协会肿瘤护理专委会2021年护理科研基金“护航”计划（SACA-HH202105）