| OBJECTIVE To assesse the effects of respiratory physiotherapy on the recovery of pulmonary function and prevention of postoperative pulmonary complications after thoracic surgery by a Meta-analysis.METHODS We searched the databases of MEDLINE/PubMed,Embase via Ovid, PEDro(Physiotherapy Evidence Database),CochraneCentral Register of Controlled Trials via Ovid and CBM and selected randomized and quasi-randomized controlled trials, in which respiratory physiotherapy was used in the pre-and/or post-operative period, in order to prevent postoperative pulmonary complications and/or recover pulmonary function after general thoracic surgery.In addition,the study quality was assessed using the PEDro scale and data analysis was performed by Review Manager5.2.3from Cochrane website.RESULTS Twelve randomized or quasi-randomized controlled trials were included(n=834patients) and all the studies achieved a PEDro score>4points.Of3studies with a "no intervention" control group and9studies compared physiotherapy treatments with conventional physiotherapy:in term of the incidence of PPC,pneumonia and atelectasis,no study found PT was not better than no-PT and NPPV,JS, HFCWO,IPT,PEP were not better than CPT;1study found a significant increase in pulmonary function with IS compared with no-PT;1study found a significant increase in pulmonary function and oxygenation,and2studies found a significant decrease in length of hospital stay with NPPV compared with CPT;1study found a significant decrease in length of hospital stay with IS compared with CPT;1study found a significant increase in pulmonary function and oxygenation with HFCWO compared with CPT;1study found a significant decrease in length of hospital stay with IPT compared with CPT.CONCLUSION The efficiency and safty of using of respiratory physiotheray in the management of thoracic surgical patients is difficult to be determined in such a Meta-analysis... |
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