摘要
目的:系统评价喉罩(LMA)与气管插管在髋关节置换手术中气道管理的安全性和有效性。方法:计算机检索Pubmed、Embase、CINAHL、The Cochrane Library、CNKI、CBM、Wan Fang Data和VIP数据库中,有关喉罩和气管插管用于髋关节置换手术的随机对照试验(RCTs),检索时限从建库至2017年10月,采用Revman 5.2软件进行Meta分析。结果:共纳入21个RCT,合计1446例患者,其中喉罩组722例,气管插管组724例。Meta分析结果显示:(1)与气管插管相比,喉罩可以降低拔管呛咳、术后咽痛和术后声嘶的发生率。(2)两组侧卧位气道压力(Paw)和呼气末CO_2分压(PetCO_2)差异无统计学意义。(3)喉罩组插入时引起的血应激指标升高小于气管插管组。(4)首次置入成功率:两组差异无统计学意义(P>0.05)。结论:基于现有证据,在髋关节置换手术中,喉罩是一种安全、有效的气道管理方式。
Objective：To systematically assess the effectiveness and safety of laryngeal mask airway（LMA） and endotracheal tube（ETT） for airway management in patients undergoing hip replacement. Methods：The Cochrane Library,Pubmed,Embase,CINAHL,CNKI,CBM,VIP and Wan Fang Data were searched from the establishment to October,2017,and the conference proceedings and relevant papers published were also searched manually to collect the relevant randomized controlled trials（RCTs）.The meta-analyses were performed by using Rev Man 5.0 software.Results：A total of 21 RCTs involving 1446 patients were included.Results of meta-analysis showed that：（1）LMA was superior to ETT in terms of less postoperative sore throat,postoperative hoarse voice and cough during extubation.（2）LMA was similar to ETT in terms of Paw and Pet CO2 in lateral position.（3）The hemodynamics and stress parameter＇s change during insertion and extraction of LMA were more stable than ETT.（4）No significant differences were found in the successful insertion on the first attempt between the LMA and ETT groups（P〉0.05）.Conclusion：Current evidence indicates that LMA is a safe and effective airway management in hip replacement.
作者
陶磊
吕蔓蔓
谢言虎
柴小青
TAO Lei;LV Man-man;XIE Yan-hu(Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, Anhui)
出处
《安徽卫生职业技术学院学报》
2018年第2期17-20,共4页
Journal of Anhui Health Vocational & Technical College
基金
安徽省卫生厅医学科研课题(编号:2013zc002)
关键词
喉罩
气管插管
系统评价
Meta分析
髋关节置换
全身麻醉
Laryngeal mask airway
Endotraeheal tube
Systematic review
Meta-analysis
Hip replacement
General anesthesia
