摘要
目的评价针刺复合颈丛麻醉和单纯颈丛麻醉运用于甲状腺手术的有效性和安全性。方法通过采用Cochrane系统评价的方法对针刺复合颈丛麻醉的随机对照试验进行系统评价。计算机检索中国期刊全文数据库(CNKI)、VIP、中国生物医学文献数据库(CBM)、万方数据库、Pubmed及Ebsco Medline,年限为2014年5月31日之前发表的文献。在排除重复、无关及非随机对照试验后,筛选出符合纳入标准的针刺复合颈丛麻醉的随机对照试验。应用PEDro量表对符合入选标准的随机对照研究进行质量评价,并用专用软件RevMan 5.2版进行统计分析。结果共纳入12篇文献,共754例患者纳入本次研究。有效性分析同质性较好,合并效应量OR=4.49,95%Cl(2.82,7.14),合并效应量的检验Z=6.33,P<0.00001,差异有统计学意义,提示针刺复合颈丛麻醉优于对照组,可以认为针刺复合颈丛麻醉可以提高麻醉的效果。术中心率分析异质性较大[WMD=﹣11.16,95%Cl(﹣16.54,﹣5.78)],提示针刺复合颈丛麻醉术中心率均低于对照组。不良反应分析,同质性较好,合并效应量OR=0.20,95%Cl(0.11,0.35),合并效应量的检验Z=5.56,P<0.00001,差异有统计学意义,提示针刺复合颈丛麻醉不良反应少于对照组。结论针刺复合颈丛麻醉相对于单纯颈丛麻醉可以提高麻醉效果,降低术中心率,减少不良反应的发生。
Objective To assess the effectiveness and safety of applying acupuncture combined cervical plexus anesthesia versus cervical plexus anesthesia alone to thyroid surgery. Method A Cochrane systematic review was conducted of randomized controlled trials of acupuncture combined cervical plexus anesthesia. China Knowledge Resource Integrated Database（CNKI）, VIP, Chinese Biomedical Literature Database（CBM）, Wanfang Database, Pubmed, Ebsco and Medline were electronically searched for the literature published before May 31 st, 2014. Randomized controlled trials of acupuncture combined cervical plexus anesthesia meeting the inclusion criteria were selected after excluding repeated, unrelated and nonrandomized controlled trials. The randomized controlled trials meeting the inclusion criteria were qualitatively assessed using the PEDro scale and a systematic analysis was made using Rev Man 5.2 software. Result A total of 12 pieces of literature with 754 patients were included in this study. An analysis of effectiveness showed good homogeneity. OR（combined effect size） =4.49, 95%CI（2.82,7.14）. Z（test for overall effect） =6.33,P〈0.00001. There was a statistically significant difference, suggesting that acupuncture combined cervical plexus anesthesia was better than in the control group. It can be considered that acupuncture combined cervical plexus anesthesia can improve the effect of the anesthesia. An analysis of intraoperative heart rate showed large heterogeneity [WMD=﹣11.16,95%Cl（﹣16.54,﹣5.78）], suggesting that the heart rate was lower than in the control group during surgery under acupuncture combined cervical plexus anesthesia. An analysis of adverse reactions showed good homogeneity. OR（combined effect size） =0.20, 95%CI（0.11,0.35）. Z（test for overall effect） =5.56,P〈0.00001. There was a statistically significant difference, suggesting that adverse reactions to acupuncture combined cervical plexus anesthesia were fewer than in the control group. Conclusion In comparison with cervical plexus anesthesia alone, acupuncture combined cervical plexus anesthesia can improve the effect of the anesthesia, decrease intraoperative heart rate and reduce the occurrence of adverse reactions.
出处
《上海针灸杂志》
2016年第2期235-240,共6页
Shanghai Journal of Acupuncture and Moxibustion
关键词
针刺麻醉
甲状腺手术
随机对照试验
综述
系统评价
Acupuncture anesthesia
Thyroid surgery
Randomized controlled trial
Review
Systematic assessment
