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电视辅助胸腔镜肺手术麻醉效果的比较:一项荟萃分析。

The comparison of anesthesia effect of lung surgery through video-assisted thoracic surgery: A meta-analysis.

作者信息

Ke Jing-Dong, Hou Hai-Jun, Wang Min, Zhang Yu-Jie

机构信息

Department of Anesthesiology, Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

J Cancer Res Ther. 2015 Nov;11 Suppl:C265-70. doi: 10.4103/0973-1482.170534.

Abstract

OBJECTIVE

The epidural anesthesia and general anesthesia are the most commonly used in lung surgery through video-assisted thoracic surgery (VATS). Each of these methods has their advantages and disadvantages, so the aim of this meta-analysis is to identify which anesthesia is more conducive to lung surgery under VATS and rehabilitation of patients.

MATERIALS AND METHODS

The Cochrane Library Database (Issue 12, 2013), PubMed (1966-2015), and China National Knowledge Infrastructure (1950-2015) were searched without language restrictions. Meta-analyses were conducted using Review Manager 5.2 software (The Cochrane Collaboration, Software Update, Oxford). We calculated odds ratio (OR) and its confidence interval (95% CI) to estimate the difference between epidural anesthesia and general anesthesia through finishing of the collected data.

RESULTS

Due to our search results, 7 studies were included in our study. Studies among them show that different contents of these articles are not all the same about research direction. Our findings suggested that epidural anesthesia had more advantages than general anesthesia for operative time (mean difference = - 23.85, 95% CI: - 29.67-- 18.03, P = 0.0001). More than that, epidural anesthesia showed a good surgical outcome on postoperative hospital stay (mean difference = - 0.43, 95% CI: - 0.85-- 0.01, P = 0.04) than general anesthesia. But we found that there were no different on numbers of people with complications (OR = 0.45, 95% CI: 0.23-0.89, P = 0.97) and headache occurrence (OR = 2.69, 95% CI: 0.62-11.70, P = 0.91) between epidural anesthesia and general anesthesia.

CONCLUSION

These results indicated that epidural anesthesia can save operating time and postoperative hospital stay time. But epidural anesthesia and general anesthesia have the same effect on complications.

摘要

目的

硬膜外麻醉和全身麻醉是电视辅助胸腔镜手术(VATS)肺手术中最常用的麻醉方式。这两种方法各有优缺点,因此本荟萃分析的目的是确定哪种麻醉方式更有利于VATS下的肺手术及患者康复。

材料与方法

检索Cochrane图书馆数据库(2013年第12期)、PubMed(1966 - 2015年)和中国知网(1950 - 2015年),无语言限制。使用Review Manager 5.2软件(Cochrane协作网,软件更新版,牛津)进行荟萃分析。通过整理收集的数据,计算比值比(OR)及其置信区间(95%CI)来估计硬膜外麻醉和全身麻醉之间的差异。

结果

根据检索结果,本研究纳入7项研究。其中研究表明,这些文章的不同内容在研究方向上并非完全相同。我们的研究结果表明,硬膜外麻醉在手术时间方面比全身麻醉更具优势(平均差=-23.85,95%CI:-29.67--18.03,P = 0.0001)。此外,硬膜外麻醉在术后住院时间方面比全身麻醉显示出更好的手术效果(平均差=-0.43,95%CI:-0.85--0.01,P = 0.04)。但我们发现,硬膜外麻醉和全身麻醉在并发症发生人数(OR = 0.45,95%CI:0.23 - 0.89,P = 0.97)和头痛发生率(OR = 2.69,95%CI:0.62 - 11.70,P = 0.91)方面没有差异。

结论

这些结果表明,硬膜外麻醉可节省手术时间和术后住院时间。但硬膜外麻醉和全身麻醉在并发症方面效果相同

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