术后切口局部浸润与硬膜外镇痛用于肝切除术患者效果的比较:meta分  

Efficacy of postoperative local incision infiltration versus epidural analgesia in patients undergoing hepatectomy:a meta-analysis

作　　者：薛小云 支晓雁[1] 马骏[2] 田毅[1] 董盛龙[1] 李岩[3] Xue Xiaoyun;Zhi Xiaoyan;Ma Jun;Tian Yi;Dong Shenglong;Li Yan(Department of Anesthesiology,Haikou People's Hospital,Central South University Xiangya School of Medical Affiliated Haikou Hospital,Haikou 570208,China;Center for Anesthesiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Pain Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]中南大学湘雅医学院附属海口医院海口市人民医院麻醉与疼痛医学科,570208 [2]首都医科大学附属北京安贞医院麻醉中心,100029 [3]首都医科大学宣武医院疼痛科,北京100053

出　　处：《中华麻醉学杂志》2019年第7期831-834,共4页Chinese Journal of Anesthesiology

基　　金：中国博士后科学基金资助项目(2019M650769);北京市博士后工作经费资助项目(2018-ZZ-108);北京市医院管理局临床医学发展专项经费资助(ZYLX201810)。

摘　　要：目的采用meta分析的方法比较术后切口局部浸润与硬膜外镇痛用于肝切除术患者的效果.方法于2017年11月检索中英文电子数据库.纳入切口局部浸润与硬膜外镇痛用于肝切除术后镇痛的临床研究.结果最终纳入5篇文献,共827例患者,切口局部浸润患者598例,硬膜外镇痛患者229例.结果显示术后24和48 h活动时硬膜外镇痛效果优于切口局部浸润.与硬膜外镇痛比较,术后切口局部浸润患者不良反应发生率低.描述性结果提示切口局部浸润可缩短肠道功能恢复时间和住院时间.2组阿片类药物剂量研究结果不一致.结论硬膜外镇痛在缓解活动时疼痛较切口局部浸润有优势,切口局部浸润不良反应发生率较低.Objective To systematically compare the efficacy of postoperative local incision infiltration and epidural analgesia in the patients undergoing hepatectomy.Methods The Chinese and English databases were searched in November 2017.The clinical trials involving application of local incision infiltration and epidural analgesia in postoperative analgesia in the patients undergoing hepatectomy were included.Results Five studies involving 827 patients were included in this meta-analysis,598 cases received local incision infiltration and 229 cases received epidural analgesia.The results of meta-analysis showed that epidural analgesia provided better efficacy than local incision infiltration during movement at 24 and 48 h after operation.The incidence of adverse reactions was significantly lower in the patients who received local incision infiltration after operation than those who underwent epidural analgesia.The descriptive results indicated that local incision infiltration can shorten the recovery time of intestinal function and length of hospital stay.The results of opioid doses studied in the two groups were inconsistent.Conclusion Epidural analgesia has an advantage over the local incision infiltration in relieving pain during movement,however,local incision infiltration has a lower incidence of adverse reactions in the patients undergoing hepatectomy.

关 键 词：外科伤口 镇痛 镇痛 硬膜外 肝切除术 Meta分析 

分 类 号：R61[医药卫生—外科学]