摘要
目的系统评价剖宫产手术中硬膜外麻醉和腰硬联合麻醉的有效性及安全性。方法计算机检索Pubmed、Cochrane library、Embase、中国知网(CNKI)、万方(Wang Fang)、维普(VIP)中对比剖宫产手术硬膜外麻醉(对照组)及腰硬联合麻醉(试验组)的随机对照试验,由两名研究者筛选文献后提取相关数据,采用Rev Man 5. 3软件进行数据分析。结果检索得文献791篇,筛除重复文献184篇,不符合要求文献592篇,共有15篇文献纳入本研究。与对照组相比,试验组可缩短手术时间(MD=-4. 62,95%CI-7. 16～-2. 04,P=0. 000 4),缩短开始手术时间(MD=-7. 06,95%CI-9. 10～-5. 02,P <0. 000 01),有利于患者达到麻醉效果Ⅰ级(OR=5. 78,95%CI 2. 39～13. 95,P <0. 000 1),增加眩晕的发生情况(OR=3. 47,95%CI 1. 44～8. 35,P=0. 006),降低颤抖发生率(OR=0. 12,95%CI 0. 02～0. 29,P <0. 000 1),其余不良反应发生情况比较差异无统计学意义(P> 0. 05)。结论剖宫产患者采用腰硬联合麻醉较硬膜外麻醉更为有效,但仅能减少麻醉过程中颤抖的发生情况。
Objective To systematically review the effect and safety of epidural anesthesia and combined spinal-epidural anesthesia in cesarean section.Methods We searched the Pubmed,Cochrane library,Embase,CNKI,Wang Fang and VIP for random control trials about comparison of epidural anesthesia(control group)and combined spinal-epidural anesthesia(trial group)in cesarean section.Two reviewers extracted data from screened literature.The data were analyzed by RevMan 5.3.Results Altogether 791 literatures were obtained by searching,184 repeating literatures and 592 literatures which did not meet with the inclusion criteria were eliminated,15 literatures were included.Comapring with the control group,the trial group had reduced surgery duration(MD=-4.62,95%CI-7.16--2.04,P=0.000 4)and shortened onset time of surgery(MD=-7.06,95%CI-9.10--5.02,P<0.000 01),helpful to reach anesthetic effect levelⅠ(OR=5.78,95%CI 2.39-13.95,P<0.000 1),increased occurrence of dizziness(OR=3.47,95%CI 1.44-8.35,P=0.006),decreased occurrence of shivering(OR=0.12,95%CI 0.02-0.29,P<0.000 1).There were no statistical difference in occurrence of other adverse effects(P >0.05).Conclusion The combined spinal-epidural anesthesia is a more effective than epidural anesthesia in cesarean section,but it can only decrease the occurrence of shivering during anesthesia.
作者
李敏
黄贻勇
张卫东
LI Min;HUANG Yiyong;ZHANG Weidong(Department of Anesthesiology,Friendship Hospital of Urumchi,Urumqi 830049,China;Department of Anesthesiology,Hongshan Traditional Chinese Medicine Hospital of Urumchi, Urumqi 830000,China;Department of Pharmacy,Karamay Central Hospital,Karamay 834000,China)
出处
《医学综述》
2019年第3期603-607,611,共6页
Medical Recapitulate
基金
新疆维吾尔自治区科技支疆项目计划(201591161)
关键词
剖宫产
硬膜外麻醉
腰硬联合麻醉
META分析
Cesarean section
Epidural anesthesia
Combined spinal-epidural anesthesia
Meta-analysis
