CAJ | 학술논문

目的采用Meta分析的方法系统评价骶管阻滞复合气管插管全麻在小儿腹腔镜手术中的临床效果和不良反应.方法计算机检索PubMed、Embase、Cochrane Library、中国知网、维普、万方数据库从建库至2014年10月的文献,对符合纳入与排除标准的研究进行资料提取和文献质量评价,并采用RevMan 5.1.5软件进行Meta分析.结果最终纳入9个随机对照实验,共计患者528例.Meta分析结果显示,与单纯全麻比较,骶管阻滞复合气管插管全麻:①循环指标心率(HR)更平稳,在气管插管前、气腹后15 min和拔管后差异有统计学意义;②呼吸指标呼气末二氧化碳分压(PETCO2)更平稳,在气腹后15 min差异有统计学意义;③诱导时间、苏醒时间以及拔管时间更短,差异有统计学意义;④术后不良反应:复合骶管阻滞组明显少于单纯全麻组,苏醒期躁动、术后恶心呕吐和随访烦躁呓语的差异有统计学意义.结论在小儿腹腔镜手术中,使用骶管阻滞复合气管插管全麻与单纯全麻比较,呼吸、循环更平稳,诱导、苏醒和拔管时间更短,不良反应发生率更低.
목적 채용Meta분석적방법계통평개저관조체복합기관삽관전마재소인복강경수술중적림상효과화불량반응.방법 계산궤검색PubMed、Embase、Cochrane Library、중국지망、유보、만방수거고종건고지2014년10월적문헌,대부합납입여배제표준적연구진행자료제취화문헌질량평개,병채용RevMan 5.1.5연건진행Meta분석.결과 최종납입9개수궤대조실험,공계환자528례.Meta분석결과현시,여단순전마비교,저관조체복합기관삽관전마:①순배지표심솔(HR)경평은,재기관삽관전、기복후15 min화발관후차이유통계학의의;②호흡지표호기말이양화탄분압(PETCO2)경평은,재기복후15 min차이유통계학의의;③유도시간、소성시간이급발관시간경단,차이유통계학의의;④술후불량반응:복합저관조체조명현소우단순전마조,소성기조동、술후악심구토화수방번조예어적차이유통계학의의.결론 재소인복강경수술중,사용저관조체복합기관삽관전마여단순전마비교,호흡、순배경평은,유도、소성화발관시간경단,불량반응발생솔경저.
Objective To evaluate the clinical effects and adverse reactions of sacral block combined with general anesthesia in pediatric laparoscopic operation. Methods Articles have been retrieved in PubMed, Embase, Cochrane Library, Chinese HowNet database, VIP, from database built to October 2014, and handled in inclusion and exclusion criteria for data extraction and quality assessment, using RevMan 5.1.5 software for Meta-analysis. Results A total of 9 randomized controlled trials were included, with a total of 528 patients. Compared with general anesthesia, heart rate in sacral block combined tracheal intubation was more stable, with statistically significant differ-ence between the two groups before tracheal intubation, 15 min after pneumoperitoneum and after extubation. The par-tial pressure of end-tidal carbon dioxide (PETCO2) in sacral block combined tracheal intubation was more stable, with significant difference 15 min after pneumoperitoneum; The induction time, wake-up time and extubation time were shorter, with statistically significant difference. The postoperative adverse reactions were significantly less, with signif-icant difference in restlessness, nausea, vomiting and balderdash. Conclusion In pediatric laparoscopic operation, sacral block combined with tracheal intubation results in more stable circular and respiratory function, shorter time of induction, wake-up and extubation, and lower incidence of adverse reactions, compared with simple general anesthesia.