摘要
目的评价全身麻醉与局部麻醉用于骨质疏松性椎体压缩性骨折患者椎体后凸成形术的临床效果。方法计算机检索Cochrane图书馆、JBI图书馆、Pubmed、Medline、EMbase、OVID、CNKI、CBM、维普和万方等数据库中关于全身麻醉与局部麻醉用于OVCF患者PKP术的随机对照试验(RCTs),同时对命中的文献进行筛选后行质量评价,纳入中高质量的文献并进行资料摘录。采用Rev Man 5.3软件进行Meta分析,结局指标包括术中失血量、手术时间、骨水泥渗漏率、神经损伤发生率、VAS评分、住院时间、术后1 d后凸角度。结果共纳入6篇RCT研究。Meta分析结果显示,局部麻醉组神经损伤发生率显著低于全身麻醉组[OR=0.16,95%CI(0.04,0.73),P=0.02<0.05],住院时间显著短于全身麻醉组[WMD=-2.80,95%CI(-3.82,-1.78),P<0.05]。但术后1 d后凸角度全身麻醉组显著优于局部麻醉组[SMD=0.39,95%CI(0.04,0.74),P=0.03<0.05]。其他指标均差异无统计学意义(P>0.05)。结论局部麻醉能够降低神经损伤发生率,缩短住院时间,但全身麻醉后凸角度恢复优于局部麻醉组,应考虑医患实际情况进行择选。
Objective To evaluate the clinical effects of general anesthesia and local anesthesia to patients undergoing percutaneous kyphoplasty for osteoporotic vertebral compression fractures.Methods Papers involving the effect of general anesthesia and local anesthesia to patients undergoing percutaneous kyphoplasty for osteoporotic vertebral compression fractures were searched in Cochrane Library,JBI Library,Pubmed,Medline,EMbase,OVID,CNKI,CBM,VIP and Wanfang Data to collect the randomized controlled trials （RCTs） by computer retrieval.A quality assessment scale was developed to identify each potentially qualified document,moderate and high quality documents were selected for data extraction.RevMan 5.3 software was used for Meta-analysis.Results indexes included intraoperative blood loss, operation time,bone cement leakage rate, nerve injury rate,VAS scores,hospital stays,postoperative kyphosis angle after I day. Results 6 eligible documents were identified for pooled analysis.The results of Meta-analyses showed that the nerve injury rate of the local anesthesia group was lower than that of the general anesthesia group [0R=0.16,95%CI （0.04,0.73）, P=0.02〈0.05],the hospital stays was shorter than that in the general anesthesia group [WMD=-2.80,95%CI （-3.82,-1.78）, P〈0.05],but the postoperative kyphosis angle after 1 day of the general anesthesia group was smaller than that of the local anesthesia [SMD=0.39,95%CI （0.04,0.74）,P=0.03〈0.05].There was no difference between general anesthesia and local anesthesia group in other indexes.Conclusion The data indicates that local anesthesia can reduce the incidence of nerve injury,shorten the hospitalization time,but kyphosis angle recovery of general anesthesia group is better than local anesthesia.Choosing anesthesia way is depending on the actual situation of patients and doctors.
作者
程康耀
莫文
刘冬梅
吕伟波
CHENG Kang-yao1, MO Wen2, LIU Dong-mei2, LYU Wei-bo1(1.Nursing College of Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;2.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,Chin)
出处
《中国当代医药》
2018年第7期13-16,共4页
China Modern Medicine
