不同麻醉方式用于骨质疏松性椎体压缩性骨折患者椎体后凸成形术效果的Meta分析.docVIP

不同麻醉方式用于骨质疏松性椎体压缩性骨折患者椎体后凸成形术效果的Meta分析 　　[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RevMan 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=0.020.05）。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。 　　[关键词]麻醉；骨质疏松性椎体压缩性骨折；椎体后凸成形术；Meta分析 　　[中图分类号] R683.2 [文献标识码] A [文章编号] 1674-4721（2018）3（a）-0013-04 　　Meta analysis of the effect of different anesthetic methods on vertebral percutaneous kyphoplasty in osteoporotic vertebral compression fractures 　　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，China 　　[Abstract]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 1 day.Results 6 eligible documents were identified for pooled analysis.The results of Meta-analyses showed that