摘要目的:基于荟萃分析评价运动处方对慢性阻塞性肺疾病（简称慢阻肺）合并呼吸衰竭的疗效。方法:全面检索PubMed、The Cochrane library、EMbase、中国知网、万方、维普、中国生物医学文献等数据库，检索时间均从建库至2023年2月1日，收集运动处方在慢阻肺合并呼吸衰竭患者中应用的随机对照试验。2名研究人员根据纳入和排除标准，独立检索文献、提取数据及进行方法学质量评价，采用Review Manager 5.3进行荟萃分析。结果:最终纳入11篇文献，共涉及862例患者。荟萃分析结果显示，运动处方有利于改善慢阻肺合并呼吸衰竭患者的肺功能［第1秒用力呼气容积（FEV 1）：标准化均数差（ SMD）=1.53（95% CI：1.28~1.78）， P<0.001；用力肺活量（FVC）： SMD=1.55（95% CI：0.25~2.84）， P=0.020；FEV 1/FVC： SMD=1.68（95% CI：0.81~2.55）， P<0.001］，气体交换能力［动脉血氧分压（PaO 2）： SMD=1.13（95% CI：0.92~1.34）， P<0.001；动脉血二氧化碳分压（PaCO 2）： SMD=-1.23（95% CI：-1.60~-0.85）， P<0.001］；提高6 min步行试验（6MWT）评分［ SMD=2.20（95% CI：1.13~3.27）， P<0.001］；减轻呼吸困难［Brog评分： SMD=-1.74（95% CI：-3.26~-0.22）， P=0.020；圣乔治呼吸问卷（SGRQ）评分： SMD=-1.10（95% CI：-1.53~-0.66）， P<0.001］；减少机械通气时间［ SMD=-2.08（95% CI：-3.33~-0.83）， P=0.001］。 结论:运动处方可以改善慢阻肺合并呼吸衰竭患者的肺功能、气体交换能力、心肺耐力，生活质量及呼吸困难程度，降低不良事件或并发症发生率，减少机械通气时间。

abstractsObjective:To assess the effect of exercise prescription on patients with chronic obstructive pulmonary disease (COPD) and respiratory failure through meta-analysis.Methods:A comprehensive search was conducted in PubMed, The Cochrane Library, EMbase, CNKI, Wanfang, VIP, and China National Knowledge Infrastructure from the database establishment date to February 1, 2023. The search included randomized controlled trials that involved exercise prescription for patients with COPD and respiratory failure. Two independent researchers conducted literature searches, data extraction, and methodological quality evaluation. Meta-analysis was performed using Review Manager 5.3.Results:A total of 11 studies with 862 patients were included in the analysis. The meta-analysis revealed that the exercise prescription was beneficial in improving lung function [forced expiratory volume in one second (FEV 1): standardized mean difference ( SMD)=1.53(95% CI: 1.28, 1.78), P<0.001; forced vital capacity (FVC): SMD=1.55(95% CI: 0.25, 2.84), P=0.020; FEV 1/FVC: SMD=1.68(95% CI: 0.81, 2.55), P<0.001], gas exchange ability [arterial partial pressure of oxygen (PaO 2): SMD=1.13(95% CI: 0.92, 1.34), P<0.001; arterial partial pressure of carbon dioxide (PaCO 2): SMD=-1.23(95% CI:-1.60, -0.85), P<0.001], improving 6 minutes walking distance test (6MWT) [ SMD=2.20(95% CI: 1.13, 3.27), P<0.001], relieving dyspnea [Borg score: SMD=-1.74(95% CI:-3.26, -0.22), P=0.020; St George′ respiratory questionnaire (SGRQ) score: SMD=-1.10(95% CI:-1.53, 0.66), P<0.001], and reducing mechanical ventilation time [ SMD=-2.08(95% CI:-3.33, -0.83), P=0.001]. Conclusion:Exercise prescription can improve the pulmonary function, gas exchange ability, cardiorespiratory endurance, quality of life, dyspnea and reduce the duration of mechanical ventilation and negative outcomes for patients with COPD and respiratory failure.