冠狀動脈繞道手術後執行心臟復健運動的成效：實證統合分析

Effect of Cardiac Rehabilitation in Postoperative Patients with Coronary Artery Bypass Grafting: A Systematic Review and Meta-analysis

背景：冠狀動脈繞道手術後常面臨身體功能的退化。心臟復健運動能提升患者在術後整體的預後。目的：本研究運用系統性實證探討及統合分析，探討心臟復健運動對冠狀動脈繞道手術後患者的成效。方法：搜尋Cochrane Library, MEDLINE, CINHAL及PubMed等資料庫，以設定的關鍵字進行文獻搜尋，共納入五篇研究，含四篇隨機控制實驗研究及一篇統合分析。研究品質以中文版Systematic Review Appraisal Sheets及Assessing Risk Bias等評讀工具進行系統性文獻回顧及隨機對照試驗研究之文獻品質評析，並使用Stata 12.0版統計軟體進行統合分析。結果：執行心臟復健運動方案後，患者的「六分鐘步行距離」有明顯增進之成效，實驗組比控制組可多步行約45.06公尺（95% Cl:2.53～87.60, random effect model, p<.05）。結論：冠狀動脈繞道手術後的患者執行心臟復健運動後可增長步行距離，實際地改善身體功能及增加活動耐受力。

Aim: Applying evidence-based systematic review and meta-analysis to evaluate the results of cardiac rehabilitation for patients receiving CABG. Methods: The database searching included Cochrane Library, MEDLINE, CINHAL and PubMed. Five articles were eligible for analysis including four randomized control trials and one meta-analysis. The qualitative evaluation of articles were appraised by Chinese edition of Systematic Review Appraisal Sheets and Assessing Risk Bias. Stata 12.0 was used for meta-analysis. Results: The results of walking distance in six minutes was significantly improved after cardiac rehabilitation. The treatment group had longer mean distance of 45.06 meters than the control group (random effect model with 95% confidence interval 2.53-87.60, p<.05). Conclusion: Postoperative cardiac rehabilitation will increase the walking distance for patients receiving CABG. Therefore it improves the general systemic function and physical activity tolerance.