早期活动对急性呼吸窘迫综合征（ARDS）患者的疗效与安全性：一项系统评价和荟萃分析。
完整摘要 · 中文译文
目的：评估早期活动对急性呼吸窘迫综合征（ARDS）患者的疗效。 方法：计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、万方数据、CBM和VIP数据库中关于ARDS患者早期活动的随机对照试验（RCTs）。检索时限为各数据库建库至2025年9月30日。由2名研究者按照Cochrane系统评价方法独立评价纳入文献质量并提取数据。采用RevMan 5.4.1软件对符合条件的研究进行Meta分析。 结果：共纳入7项随机对照试验，其中英文文献4篇，中文文献3篇。Meta分析结果显示，与常规治疗相比，早期活动显著降低了重症监护病房获得性肌无力（ICU-AW）的发生率[OR = 0.35，95% CI（0.19，0.64），P = 0.0006]和谵妄的发生率[OR = 0.51，95% CI（0.28，0.91），P = 0.02]，缩短了机械通气时间[MD = -2.40，95% CI（-2.96，-1.84），P < 0.00001]、重症监护病房住院时间[MD = -3.36，95% CI（-4.21，-2.52），P < 0.00001]和总住院时间[MD = -2.74，95% CI（-3.49，-1.98），P < 0.00001]。同时，它改善了患者的功能独立性评分（巴氏指数）[MD = 17.27，95% CI（11.18，23.35），P < 0.00001]，并降低了并发症的发生率[OR = 0.39，95% CI（0.17，0.86），P = 0.02]。所有合并效应量均具有统计学意义。 结论：早期活动对ARDS患者具有显著的临床获益。 患者，改善短期临床结局和功能恢复。值得临床推广应用。然而，仍需要多中心、大样本、方法学标准化的随机对照试验（RCT）来进一步验证其长期效果和最佳实施方案。
完整摘要 · 英文原文
OBJECTIVE: To evaluate the effect of early mobilization in patients with acute respiratory distress syndrome (ARDS). METHODS: Computerized searches were conducted in PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, Wanfang Data, CBM, and VIP databases for randomized controlled trials (RCTs) on early mobilization in ARDS patients. The retrieval period was from the establishment of each database to September 30, 2025. Two reviewers independently assessed the quality of included literature and extracted data in accordance with Cochrane systematic review methodology. Meta-analysis was performed using RevMan 5.4.1 software for eligible studies. RESULTS: A total of 7 RCTs were included, consisting of 4 English and 3 Chinese articles. Meta-analysis showed that compared with conventional treatment, early mobilization significantly reduced the incidence of intensive care unit-acquired weakness (ICU-AW) [OR = 0.35, 95% CI (0.19,0.64), P = 0.0006] and delirium [OR = 0.51, 95% CI (0.28,0.91), P = 0.02], shortened the duration of mechanical ventilation [MD = -2.40,95% CI (-2.96,-1.84), P < 0.00001], length of ICU stay [MD = -3.36, 95% CI (-4.21,-2.52), P < 0.00001] and total hospital stay [MD = -2.74,95% CI (-3.49,-1.98), P < 0.00001]. Meanwhile, it improved patients'functional independence score (Barthel Index) [MD = 17.27, 95% CI (11.18, 23.35), P < 0.00001] and decreased the incidence of complications [OR = 0.39, 95% CI (0.17, 0.86), P = 0.02]. All pooled effects were statistically significant. CONCLUSION: Early mobilization yields significant clinical benefits for ARDS patients, improving short-term clinical outcomes and functional recovery. It is worthy of clinical promotion and application. However, multicenter, large-sample, and methodologically standardized RCTs are still needed to further verify its long-term effects and optimal implementation protocols.