非小细胞肺癌患者围术期运动有效性的系统评价再评价研究

背景　运动对非小细胞肺癌患者有益，但目前研究结论各异、方法学质量良莠不齐，干扰了实践成果的转化和临床决策的应用。目的　对非小细胞肺癌患者围术期运动有效性的系统评价进行再评价。方法　计算机检索中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方数据知识服务平台（Wanfang Data）、维普数据库（VIP）、PubMed、The Cochrane Library、CINAHL、EBSCO、Ovid、Web of science、EMBase、Elsevier ScienceDirect数据库，检索时限为建库至2019-05-01发表的有关非小细胞肺癌围术期运动有效性的系统评价研究，采用AMSTAR 2工具和PRISMA声明对纳入研究进行方法学和报告质量评价。结果　共纳入9篇文献，AMSTAR 2评价结果显示2项研究质量中等，3项研究质量低，4项研究质量极低，条目3、7、10报告缺失（报告率<50%）；PRISMA评价结果显示条目2、4、11、22、24、27完整报告率低。术前运动可能提高非小细胞肺癌患者的运动能力、减少术后并发症风险、缩短住院时长及术后胸管/肋间导管带管时长；术后运动对患者运动能力、肺功能、健康相关生活质量的影响不同，研究结果存在差异。结论　非小细胞肺癌患者围术期运动有效性系统评价的方法学质量和报告质量有待提高；本研究结果可为未来非小细胞肺癌运动研究的选题、研究设计及成果报告提供借鉴。

Effectiveness of Perioperative Exercise in Patients with Non-small Cell Lung Cancer：an Overview of Systematic Reviews

Background　Appropriate physical exercise is beneficial for patients with non-small cell lung cancer （NSCLC）.However，due to controversial results and uneven methodological quality of current studies about this，the transformation of practical results and application of clinical decisions are hindered.Objective　To conduct an overview of systematical reviews of the effectiveness of perioperative exercise in patients with NSCLC.Methods　Databases of CNKI，CBM，WanFang Data，VIP，PubMed，The Cochrane Library，CINAHL，EBSCO，Ovid，Web of Science，EMBase and Elsevier ScienceDirect were searched to collect systematic reviews of the effectiveness of perioperative exercise in NSCLC patients included from inception to May 1，2019.AMSTAR 2 and PRISMA statement were used to assess the methodological quality and the reporting quality of included studies，respectively.Results　A total of 9 systematic reviews were included.Analysis showed that the methodological quality of 2，3，and 4 reviews were moderate，low，and critically low，respectively〔items 3，7 and 10 evaluation results were missing （report rate <50%）〕.The evaluation results of PRISMA statement showed that the reporting rates of items 2，4，11，22，24，and 27 were low.All the reviews concluded that preoperative exercise may improve the exercise capacity，reduce the risk of postoperative complications，shorten the length of hospitalization，and duration of postoperative thoracic/intercostal chest tube drainage.However，they had controversies on the degree of improvement in exercise capacity，lung functions，and health-related quality of life.Conclusion　The methodological quality and reporting quality of the systemic reviews of perioperative exercise effectiveness in NSCLC patients need to be improved.The results of this study can provide a reference for topic selection，research design and achievement reports of future research.