肺移植患者运动康复障碍与促进因素的范围综述

doi:10.3761/j.issn.2096-7446.2026.11.019

摘要/Abstract

摘要：

目的系统分析肺移植患者术后运动康复的障碍与促进因素，为临床实践提供依据。方法按照范围综述方法学规范，检索中英文数据库PubMed、Web of Science、CINAHL、Embase、Cochrane Library、中国知网、万方数据库等，检索时限为建库至2025年6月30日。纳入与运动康复障碍和促进因素相关的原始研究，采用实施性研究综合框架进行归类与分析。结果最终纳入15篇文献，包括量性研究9篇、质性研究5篇及混合研究1篇。结果显示，肺移植患者的康复依从性总体中等，约半数患者术后能坚持训练，但随时间延长依从性逐渐下降，术后≥3年患者的依从性得分较术后1~2年下降20%以上。共提炼21个障碍因素与17个促进因素。障碍因素中，个体因素占比最高（54.43%），外部因素次之（25.31%）；促进因素中，创新因素占比最大（29.41%），个体因素次之（25.49%）。主要障碍因素为运动认知不足、体力下降、心理负担、缺乏社会与政策支持及医疗人力不足；主要促进因素为个性化康复计划、远程与现场结合的干预模式、社会与家庭支持、医疗团队指导以及自我效能感提升。结论肺移植患者术后运动康复受多维度因素影响，存在依从性不足和维持困难。未来研究需着重制订标准化康复方案，优化医疗资源配置，强化患者自我管理能力，并推广远程康复技术，根据个体需求提供灵活康复模式以提高依从性和康复效果。

关键词: 肺移植, 运动康复, 障碍因素, 促进因素, 范围综述, 循证护理学

Abstract:

Objective To systematically analyze the barriers and facilitators of exercise rehabilitation in lung transplant recipients and provide evidence for practice. Methods Following the scoping review method，major English and Chinese databases（e.g.，PubMed，Web of Science，CINAHL，Embase，Cochrane Library，CNKI，Wanfang） were searched from inception to June 30，2025. Original studies on barriers and facilitators of exercise rehabilitation after lung transplantation were included. Data were synthesized using the Consolidated Framework for Implementation Research（CFIR）. Results A total of 15 studies were included，comprising nine quantitative，five qualitative，and one mixed-methods study. The findings indicated that overall adherence was moderate，with about half of the patients maintaining postoperative participation. However，adherence declined over time，and among those 3 years after transplantation，scores were more than 20% lower compared with patients within 1~2 years. Twenty-one barriers and 17 facilitators were identified. Among the barriers，individual-level factors accounted for the largest proportion（54.43%），followed by external factors（25.31%）. Among the facilitators，innovation-related factors were the most frequent（29.41%），followed by individual-level factors（25.49%）. The main barriers included limited awareness of exercise，reduced physical capacity，psychological distress，limited social/policy support and insufficient healthcare staffing. The main facilitators included individualized rehabilitation plans，combined remote and in-person interventions，family and social support，professional guidance from healthcare teams，and enhancement of self-efficacy. Conclusion Exercise rehabilitation after lung transplantation is influenced by multiple domains and is challenged by suboptimal adherence and difficulties in long-term maintenance. Future research should focus on the development of standardized rehabilitation protocols，optimization of healthcare resources，reinforcement of patients’ self-management abilities，and broader adoption of tele-rehabilitation. Tailored and flexible programs that meet individual needs are key to improv ing adherence and outcomes.

Key words: Lung Transplantation, Exercise Rehabilitation, Barriers, Facilitators, Scoping Review, Evidence-Based Nursing

章骥韬, 曾妃, 梁江淑渊. 肺移植患者运动康复障碍与促进因素的范围综述[J]. 中华急危重症护理杂志, 2026, 7(11): 1391-1397.

ZHANG Jitao, ZENG Fei, LIANG Jiangshuyuan. Barriers and facilitators to exercise rehabilitation in lung transplant recipients：a scoping review[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(11): 1391-1397.

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