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不同类型麻醉对糖尿病患者术中血糖的影响:一项遵循PRISMA标准的系统评价和荟萃分析

Effect of different types of anesthesia on intraoperative blood glucose of diabetic patients: A PRISMA-compliant systematic review and meta-analysis.

作者信息

Li Xueqiong, Wang Jinjing, Chen Kang, Li Yijun, Wang Haibin, Mu Yiming, Chen Yaolong

机构信息

Department of Endocrinology, Chinese PLA General Hospital, Beijing Department of Gerontology, First Affiliated Hospital of Kunming Medical University, Kunming Affiliated Hospital of Academy of Military Medical Sciences (PLA 307 Hospital) Department of Endocrinology, Chinese PLA General Hospital, Beijing Evidence-Based Medicine Center, Basic Medical Sciences, Lanzhou University, Lanzhou, China.

出版信息

Medicine (Baltimore). 2017 Mar;96(13):e6451. doi: 10.1097/MD.0000000000006451.

Abstract

BACKGROUND

Systematic review which analyzes the impact of different anesthesia on intraoperative blood glucose levels of diabetes patients.

METHODS

We searched Medline (via PubMed), Embase, Cochrane Library, Web of Science, Wangfang, CNKI, and CBM database through June 2016, included in randomized controlled trial (RCT), about different anesthesia on intraoperative blood glucose levels in patients with diabetes. Two researchers in 1 group independently screened literatures with eligibility criteria, extracted information, and used RevMan5.3 software to perform meta-analysis.

RESULTS

We included 11 trials and performed the meta-analysis with 10 trials. The meta-analysis results suggested that compared with general anesthesia, the combined general-epidural anesthesia has a better glycemic control in intraoperative blood glucose levels (WMD -1.26, 95% confidence interval [CI] -1.77 to 0.76), the epidural anesthesia had no significant effects compared with general anesthesia (WMD -0.74, 95% CI 4.41-2.92), and the combined spinal-epidural anesthesia had no significant effects compared with epidural anesthesia (WMD -0.28, 95% CI -1.02 to 0.46). One study suggested that compared with epidural anesthesia, the combined general-epidural anesthesia can lower blood glucose levels CONCLUSION:: Existing evidence showed that compared with general anesthesia, the combined general-epidural anesthesia has a better glycemic control in intraoperative blood glucose levels.

摘要

背景

系统评价分析不同麻醉方式对糖尿病患者术中血糖水平的影响。

方法

检索截至2016年6月的Medline(通过PubMed)、Embase、Cochrane图书馆、Web of Science、万方、知网和中国生物医学文献数据库,纳入关于不同麻醉方式对糖尿病患者术中血糖水平影响的随机对照试验(RCT)。1组的两名研究人员独立根据纳入标准筛选文献、提取信息,并使用RevMan5.3软件进行荟萃分析。

结果

我们纳入了11项试验,并对其中10项进行荟萃分析。荟萃分析结果表明,与全身麻醉相比,全身 - 硬膜外联合麻醉在术中血糖水平的血糖控制方面更好(加权均数差[WMD] -1.26,95%置信区间[CI] -1.77至0.76),硬膜外麻醉与全身麻醉相比无显著影响(WMD -0.74,95% CI 4.41 - 2.92),腰麻 - 硬膜外联合麻醉与硬膜外麻醉相比无显著影响(WMD -0.28,95% CI -1.02至0.46)。一项研究表明,与硬膜外麻醉相比,全身 - 硬膜外联合麻醉可降低血糖水平。结论:现有证据表明,与全身麻醉相比,全身 - 硬膜外联合麻醉在术中血糖水平的血糖控制方面更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4bf/5380261/f5a2316aa3d1/medi-96-e6451-g001.jpg

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