七氟醚用于冠脉搭桥术中心肌保护效应的荟萃分析  

The effect of cardioprotective with sevoflurane in patients undergoing coronary artery bypass grafting:a meta-analysis

作　　者：陈林[1] 郑宏[1] 张梅[1] 张兰[1] 

机构地区：[1]新疆医科大学第一附属医院麻醉科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2010年第10期1242-1247,共6页Journal of Xinjiang Medical University

摘　　要：目的对于七氟醚用于冠状动脉搭桥手术的心肌保护作用进行荟萃分析。方法按照Coharane系统评价制作方法,通过检索PubMed数据库、Ovid数据库、EMBASE数据库、Medline光盘数据库、同方数据库检索相关文献,并手工检索相关杂志,对所有文献的参考文献进行进一步的检索。收集所有相关的随机对照试验,采用Cocharane协作网提供的RevMan4.2软件进行Meta分析,以获得七氟醚用于冠状动脉搭桥手术的心肌保护作用的相关证据。结果经过全面检索及筛查后,共纳入7篇进入本研究,共计616例患者。Meta分析表明:七氟醚与异丙酚用于冠脉搭桥术中中心静脉压、心肌梗死的发生率和术后肌酸激酶同功酶等方面没有明显区别。而在平均动脉压、心脏指数和术后肌钙蛋白的变化等方面有统计学意义。结论七氟醚用于冠状动脉搭桥手术中在平均动脉压、心脏指数的变化以及术后肌钙蛋白的变化方面与对照组相比差异具有统计学意义,但在中心静脉压、术后心梗发生率以及肌酸肌酶同工酶方面两组相比差异无统计学意义。七氟醚在冠脉搭桥术中的心肌保护作用得以证实,但是并不能降低术后心肌梗死的发生率。Objective To evaluate the effect of cardioprotective with sevoflurane in patients undergoing coronary artery bypass grafting.Methods We searched the Cochrane Central Register of Controlled Trials-Central,Pubmed,Ovid,EMBASE,Medline large databases.Several relevant journals were also hand searched.All of the literature references were further searched.Language was restricted in English and chinese.The quality of included trials was assessed.Meta-analysis were conducted using the Cochrane Collaboration,s RevMan 4.2 software.Results Seven eligible studies involving 616 patients were included in the rview.Meta analysis shows that for patients undergoing coronary artery bypass grafting with sevoflurane and propfol there is no significant in central venous pressure during the operation.The incidence of myocardial infarction,CK-MB after the operation.But there was differences in Mean arterial blood pressure（MAP）,Cardiac index during the operation,the troponin I after operation.Conclusion There are some differences between sevoflurane and propfol on coronary artery bypass grafting in MAP,Cardiac index（CI）during the operation.The troponin I（cTnI）after operation,but there is no difference in central venous pressure during the operation.The incidence of myocardial infarction,CK-MB after the operation.So the cardioprotective of sevoflurane in patients undergoing coronary artery bypass grafting were confirmed,but it could not reduce the incidence of myocardial infarction after operation.

关 键 词：七氟醚 冠脉搭桥 心肌保护 随机对照试验 

分 类 号：R614[医药卫生—麻醉学]