张添羽：研究设计、文献检索及筛选、数据整理及分析、论文撰写；程玲灵：文献筛选、数据分析、质量评价；程臻：数据整理、质量评价；邵微颖：文献筛选；石爱丽：研究指导、论文修改、经费支持
收稿日期: 2025-05-13
网络出版日期: 2026-04-28
基金资助
浙江省医药卫生科技计划项目(2025KY609)
The effect of early mobilization in adult patients with extracorporeal membrane oxygenation：a meta-analysis
Received date: 2025-05-13
Online published: 2026-04-28
Supported by
Zhejiang Province Health and Science Research Foundation Project(2025KY609)
目的 评价早期活动在体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）患者中的干预效果。方法 计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane Library和Web of Science数据库，检索时限为建库至2025年3月17日。由2名研究者独立检索并筛选文献，进行文献质量评价后，采用RevMan 5.4软件进行Meta分析。结果 共纳入8篇文献，总计9 054例患者。Meta分析结果显示，与非早期活动组相比，早期活动可降低ECMO患者的病死率，差异具有统计学意义[RR=0.65，95%CI（0.46，0.93），P<0.001]，但在机械通气时长[SMD=-0.37，95%CI（-1.46，0.72），P=0.510]及ECMO支持时间[SMD=-0.33，95%CI（-0.86，0.20），P= 0.220]方面，干预效果尚不明确。在亚组分析中，静脉-静脉ECMO和静脉-动脉ECMO患者病死率差异具有统计学意义[RR=1.34，95%CI（1.05，1.71），P=0.020]。结论 早期活动的干预能降低ECMO患者的病死率，但受到纳入研究质量、研究对象数量及研究结果异质性的限制，仍需更多高质量研究进一步验证早期活动在ECMO患者中的安全性、可行性和有效性，并针对不同类型的ECMO患者制订专业的渐进式活动方案。
张添羽 , 程玲灵 , 程臻 , 邵微颖 , 石爱丽 . 早期活动对成人体外膜肺氧合患者临床结局影响的Meta分析[J]. 中华急危重症护理杂志, 2026 , 7(5) : 616 -622 . DOI: 10.3761/j.issn.2096-7446.2026.05.017
Objective This study aims to evaluate the effect of early mobilization in patients with extracorporeal membrane oxygenation（ECMO）. Methods The databases of CNKI，Wanfang，VIP，CBM，PubMed，Embase，Cochrane Library，and Web of Science were searched by computer，and the retrieval time was from the establishment of the database to March 17，2025. Two researchers independently searched and screened the literature，and evaluated the quality of the literature. RevMan 5.4 software was used for meta-analysis. Results A total of 8 studies involving 9 054 patients were included. The results of meta-analysis showed that，compared with the non-early mobilization group，early mobilization could reduce the mortality of ECMO patients，and the difference was statistically significant[RR=0.65，95%CI（0.46，0.93），P<0.001]. However，the effect on the duration of mechanical ventilation[SMD=-0.37，95%CI（-1.46，0.72），P=0.510] and ECMO support[SMD=-0.33，95%CI（-0.86，0.20），P=0.220] was not clear. In subgroup analysis，there was a statistically significant difference in mortality between patients with veno-venous extracorporeal membrane oxygenation（V-V ECMO） and veno-arterial extracorporeal membrane oxygenation（V-A ECMO）[RR=1.34，95%CI（1.05，1.71），P=0.020]. Conclusion The intervention of early mobilization can reduce the mortality of ECMO patients. But it is limited by the quality of the included studies，the number of subjects and the heterogeneity of study results，more high-quality studies are still needed to further verify the safety，feasibility and effectiveness of early mobilization in ECMO patients，and formulate professional progressive mobilization programs for different types of ECMO patients.
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