CAJ | 학술논문

目的采用Meta分析比较心脏手术患者瑞芬太尼复合麻醉与芬太尼或舒芬太尼复合麻醉的效果.方法检索Cochrane图书馆、PubMed、EMBASE、OVID和中国生物医学文献数据库,收集心脏手术患者瑞芬太尼复合麻醉与芬太尼或舒芬太尼复合麻醉效果比较的临床随机对照研究.采用Cochrane协作网系统评价法评价纳入文献的质量,评价指标包括:术后机械通气时间、总住院时间和围术期心肌肌钙蛋白水平、病死率、正性肌力药使用率、痛觉过敏发生率和心肌梗死发生率.采用RevMan 5.0软件进行Meta分析.结果共纳入16项研究,包括1473例患者,其中芬太尼组或舒芬太尼组664例,瑞芬太尼组573例.与芬太尼组或舒芬太尼组相比,瑞芬太尼组术后机械通气时间和总住院时间缩短,围术期心肌肌钙蛋白水平和正性肌力药物使用率降低(P＜0.05),围术期病死率、痛觉过敏和心肌梗塞的发生率差异无统计学意义(P＞0.05).结论心脏手术患者瑞芬太尼复合麻醉的效果优于芬太尼或舒芬太尼复合麻醉.
목적 채용Meta분석비교심장수술환자서분태니복합마취여분태니혹서분태니복합마취적효과.방법 검색Cochrane도서관、PubMed、EMBASE、OVID화중국생물의학문헌수거고,수집심장수술환자서분태니복합마취여분태니혹서분태니복합마취효과비교적림상수궤대조연구.채용Cochrane협작망계통평개법평개납입문헌적질량,평개지표포괄:술후궤계통기시간、총주원시간화위술기심기기개단백수평、병사솔、정성기력약사용솔、통각과민발생솔화심기경사발생솔.채용RevMan 5.0연건진행Meta분석.결과 공납입16항연구,포괄1473례환자,기중분태니조혹서분태니조664례,서분태니조573례.여분태니조혹서분태니조상비,서분태니조술후궤계통기시간화총주원시간축단,위술기심기기개단백수평화정성기력약물사용솔강저(P＜0.05),위술기병사솔、통각과민화심기경새적발생솔차이무통계학의의(P＞0.05).결론 심장수술환자서분태니복합마취적효과우우분태니혹서분태니복합마취.
Objective To compare the efficacy of rcmifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.Methods We searched the Coehrane library,PubMed,EMBASE,OVID and Chinese Biomedical Database for prospective randomized controlled trials involving the comparison of the efficacy of remifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the mechanical ventilation time after operation,duration of stay in hospital,and level of cardiac troponin,mortality,requirement for positive inotropic drugs and incidence of hyperalgesia and myocardial infarction during perioperative period.Meta-analysis was conducted using the RevMan 5.0 software.Results Sixteen prospective randomized controlled trials involving 1473 patients were included in our Meta-analysis.The patients were divided into 2 groups:fentanyl or sufentanil group ( n =644) and remifentanil group ( n =573).Compared with fentanyl or sufentanil group,the mechanical ventilation time after operation and duration of stay in hospital were significantly shortened,the level of cardiac troponin during the perioperative period was significantly decreased and the requirement for positive inotropic drugs during the perioperative period was significantly reduced ( P ＜ 0.05),and no significant change was found in the incidence of hyperalgesia or mortality of myocardial infarction during the perioperative period in remifentanil group ( P ＞ 0.05 ).Conclusion The efficacy of remifentanil combined anesthesia is better than that of fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.