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目的 系统评价远程医疗在心血管疾病患者心脏运动康复中的效果。方法 计算机检索CINAHL Complete、PubMed、EMbase、Web of Science、中国生物医学文献数据库、中华医学期刊全文数据库、中国知网、万方数据知识服务平台和维普中文科技期刊数据库中关于远程医疗应用于心血管疾病患者心脏运动康复的随机对照试验文献。检索时限为建库至2025年6月30日。采用RevMan 5.4进行Meta分析。结果 纳入20篇文献，共计2 234例心血管疾病患者。Meta分析结果显示，与传统心脏运动康复相比，远程心脏运动康复可显著提高患者峰值摄氧量[MD=1.61,95%CI(0.72,2.50),P<0.001]、6 min步行距离[MD=44.55,95%CI(17.51,71.59),P=0.001]。亚组分析表明，超过3个月的远程康复干预在6 min步行距离上效果更优；基于APP与可穿戴设备（尤其推荐加速度计）的远程技术对6 min步行距离改善更为明显。结论 远程医疗可提高心血管疾病患者的峰值摄氧量及6 min步行距离，并在改善生活质量方面具有巨大的潜力。未来研究应进一步探索融合智能传感器，实现对患者运动过程的实时、无感知、精准监测，从而更客观、连续地评估康复效果，并为个性化调整康复方案提供数据支持。
Abstract：Objective To systematically evaluate the effectiveness of telemedicine in exercise-based cardiac rehabilitation in patients with cardiovascular.Methods Randomized controlled trials of telemedicine for exercise-based cardiac rehabilitation in patients with cardiovascular disease were retrieved from CINAHL Complete,PubMed,Embase,Web of Science,SinoMed,the Chinese Medical Journal Full-text Database,CNKI,Wanfang Data,and the VIP Database.The databases were searched from inception to June 30,2025.Meta-analysis was performed using RevMan 5.4.Results A total of 20 studies involving 2,234 patients with cardiovascular disease were included.Meta-analysis showed that,compared with conventional exercise-based cardiac rehabilitation,telemedicine-based cardiac rehabilitation significantly improved peak oxygen uptake [MD=1.61,95%CI(0.72,2.50),P<0.001] and 6-minute walk distance [MD=44.55,95%CI(17.51,71.59),P=0.001].Subgroup analysis showed that interventions lasting more than 3 months produced greater improvements in 6-minute walk distance and that APP and wearable device-based remote technologies,particularly those using accelerometers,produced more pronounced improvements in 6-minute walk distance.Conclusion Telemedicine can improve peak oxygen uptake and 6-minute walk distance and has considerable potential to improve quality of life.Future studies should further explore the integration of smart sensors to enable real-time,unobtrusive,and accurate monitoring of patients during exercise,thereby allowing more objective and continuous evaluation of rehabilitation outcomes and providing data to support individualized adjustment of rehabilitation programs.
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基本信息:
中图分类号:R473.5
引用信息:
[1]王园,蔡真,宋娜,等.远程医疗对心血管疾病患者心脏运动康复效果的Meta分析[J].护理管理杂志,2026,26(09):754-759.
基金信息:
襄阳市中心医院院内科研课题（2023YB10）
2026-09-10
2026-09-10