胸段硬外麻复合全麻对单肺通气病人肺内分流和动脉氧合的系统评价
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摘要
目的系统评价胸段硬外麻复合全麻与单纯全麻对单肺通气(OLV)病人肺内分流和动脉氧合的影响。
方法计算机检索Cochrane library(2009年第4期)、Cochrane协作网麻醉组专业协作组数据库、Pubmed(1966～2009.12)、EMbase(1966～2009、12)、中国生物医学文献数据库(CBM,1978～2009、12);维普中文期刊数据库(VIP,1989～2009、12);清华同方(CNKI,1915～2009、12),手工检索临床麻醉学杂志,中华麻醉学杂志,收集胸段硬外麻复合全麻与单纯全麻对单肺通气病人肺内分流和动脉氧合的临床随机对照试验(randomized controlled trials,RCTs),由两名评价员独立采用RevMan 5.0软件对符合要求的纳入研究进行方法学质量评价和Meta分析。
结果共纳入10个研究,包括506例患者。Meta分析结果显示,在OLV后5、15、20、30及60 min几个时点,肺内分流和动脉氧合差异均无统计学意义。
结论胸段硬外麻复合全麻与单纯全麻对单肺通气肺内分流和动脉氧合的影响无明显差别,均可以安全用于OLV胸科手术患者。本系统评价纳入研究的方法学质量不高,病例数较少,因此仍需开展更多高质量、大样本随机对照试验进一步评价。
0bjective To evaluate the effectiveness of thoracic epidural anesthesia(TEA) combined with general anesthesia(GA) versus general anesthesia(GA) on arterial oxygenation and intrapulmonary shunting during one-lung ventilation (OLV)
Methods We conducted an electronic search of the literature in the Cochrane Library (Issue4,2009),the specialized trials registered in the Cochrane anesthesia group,PubMed(1966 to Dec.2009),EMbase(1966 to Dec.2008),CBM(1978 to Dec.2009),VIP(1989 to Dec.2009),CNKI(1915 to Dec.2009)and hand searched some Clinical anesthesia Journals and Chinese anesthesia journals.Randomized controlled trials (RCTs) of the effectiveness of TEA combined with GA versus GA on arterial oxygenation and intrapulmonary shunting during OLV were included,The methodological quality of included RCTs was evaluated by two reviewers independently,Meta-analysis was conducted using RevMna 5.0 software.
Results ten RCTs including 506 patients were identified.The results of meta-analyses showed that there were no significant differences in arterial oxy- genation and intrapulmonary shunting during OLV at different times of 5,15,20,30,and 60minutes after OLV.
Conclusion Both TEA combined with GA and GA have no significant diff- erences in arterial oxygenation and intrapulmonary shunting during OLV,and have the same Security during OLV.But owing to the low quality and small sample size of the included studies,so more well-designed,large sample size RCTS are needed.
方法计算机检索Cochrane library(2009年第4期)、Cochrane协作网麻醉组专业协作组数据库、Pubmed(1966～2009.12)、EMbase(1966～2009、12)、中国生物医学文献数据库(CBM,1978～2009、12);维普中文期刊数据库(VIP,1989～2009、12);清华同方(CNKI,1915～2009、12),手工检索临床麻醉学杂志,中华麻醉学杂志,收集胸段硬外麻复合全麻与单纯全麻对单肺通气病人肺内分流和动脉氧合的临床随机对照试验(randomized controlled trials,RCTs),由两名评价员独立采用RevMan 5.0软件对符合要求的纳入研究进行方法学质量评价和Meta分析。
结果共纳入10个研究,包括506例患者。Meta分析结果显示,在OLV后5、15、20、30及60 min几个时点,肺内分流和动脉氧合差异均无统计学意义。
结论胸段硬外麻复合全麻与单纯全麻对单肺通气肺内分流和动脉氧合的影响无明显差别,均可以安全用于OLV胸科手术患者。本系统评价纳入研究的方法学质量不高,病例数较少,因此仍需开展更多高质量、大样本随机对照试验进一步评价。
0bjective To evaluate the effectiveness of thoracic epidural anesthesia(TEA) combined with general anesthesia(GA) versus general anesthesia(GA) on arterial oxygenation and intrapulmonary shunting during one-lung ventilation (OLV)
Methods We conducted an electronic search of the literature in the Cochrane Library (Issue4,2009),the specialized trials registered in the Cochrane anesthesia group,PubMed(1966 to Dec.2009),EMbase(1966 to Dec.2008),CBM(1978 to Dec.2009),VIP(1989 to Dec.2009),CNKI(1915 to Dec.2009)and hand searched some Clinical anesthesia Journals and Chinese anesthesia journals.Randomized controlled trials (RCTs) of the effectiveness of TEA combined with GA versus GA on arterial oxygenation and intrapulmonary shunting during OLV were included,The methodological quality of included RCTs was evaluated by two reviewers independently,Meta-analysis was conducted using RevMna 5.0 software.
Results ten RCTs including 506 patients were identified.The results of meta-analyses showed that there were no significant differences in arterial oxy- genation and intrapulmonary shunting during OLV at different times of 5,15,20,30,and 60minutes after OLV.
Conclusion Both TEA combined with GA and GA have no significant diff- erences in arterial oxygenation and intrapulmonary shunting during OLV,and have the same Security during OLV.But owing to the low quality and small sample size of the included studies,so more well-designed,large sample size RCTS are needed.
引文
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