关键词: 冠状动脉旁路移植术, 吸气肌训练, 随机对照试验, 系统评价

Abstract: Objective: To evaluate the effectiveness of postoperative inspiratory muscle training(IMT) among patients underwent coronary artery bypass grafting(CABG). Methods: Web of Science, Cochrane Library, EMBASE, PubMed, CINAHL, CNKI, CBM, Wanfang and VIP databases were used as the source of literatures and all randomized controlled trials(RCTs) that reported the effectiveness of postoperative IMT among CABG patients were extracted from the establishment of the database to Feb 15, 2022. RevMan 5.3 was used for meta-analysis. Results: After screening, 7 English and 3 Chinese literatures were included, a total of 410 patients with CABG were included in this systematic review. The results showed that compared with patients without postoperative IMT, IMT after CABG could significantly improve maximum inspiratory pressure [weight mean difference (WMD) =19.36, 95%CI:11.77~26.95, P<0.001], maximal expiratory pressure(WMD=24.14, 95%CI:4.13~44.16, P=0.02), forced expiratory volume in one second(WMD=0.31, 95%CI:0.19~0.44, P<0.001), PaO2 (WMD=6.75, 95%CI:2.37~11.12, P=0.003), peak oxygen uptake (WMD=-3.31, 95%CI:-4.67~-1.95, P<0.001) and six-minute walk distance(WMD=79.14, 95%CI: 41.97~116.31, P<0.001), meanwhile, reduce duration of mechanical ventilation(WMD=-5.54, 95% CI:-7.47~-3.62, P<0.001) and hospitalization days(WMD=-1.26, 95%CI:-1.85~-0.66，P<0.001). Conclusion: For patients underwent CABG, postoperative IMT is a simple and acceptable stage II cardiac rehabilitation method. It can maximize patients’ postoperative physical function, reduce the occurance of adverse events and improve the long-term prognosis.

Key words: Coronary artery bypass grafting, Inspiratory muscle training, Randomized controlled trial, Systematic review