术中唤醒麻醉与传统全身麻醉下手术治疗语言功能区胶质瘤疗效的Meta分析  

Meta-analysis of the efficacy of surgical removal under awake anesthesia and general anesthesia for glioma in eloquent area

作　　者：张坤源 廖长品 彭磊 燕鹏 李沛隆 李廷阳[3] 魏芳芳[5] ZHANG Kun-yuan;LIAO Chang-pin;PENG Lei;YAN Peng;LI Pei-long;LI Ting-yang;WEI Fang-fang(Graduate School of Youjiang Medical University for Nationalities;Department of Neurosurgery,Affiliated Hospital of Youjiang Medical University for Nationalities;Department of Neurosurgery,Baise People's Hospital,Baise,Guangxi 533000;Graduate School of North Sichuan Medical College,Nanchong,Sichuan 637000;Department of Anesthesiology,Baise People's Hospital,Baise,Guangxi 533000)

机构地区：[1]右江民族医学院研究生学院 [2]右江民族医学院附属医院神经外科 [3]百色市人民医院神经外科,广西百色533000 [4]川北医学院研究生学院,四川南充637000 [5]百色市人民医院麻醉科,广西百色533000

出　　处：《赣南医学院学报》2022年第1期49-56,共8页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨术中唤醒麻醉与传统全身麻醉下手术切除神经胶质瘤的疗效与安全性。方法:检索PubMed、EMbase、Cochrane、中国知网、维普、万方等数据库,搜索自数据库创立至2020年2月关于对比术中唤醒麻醉与传统全身麻醉下手术切除语言功能区神经胶质瘤的研究,使用Rev Man 5.3软件进行Meta分析。结果:共纳入13项研究,其中前瞻队列研究4项,回顾病例对照研究9项,1023例研究对象中,术中唤醒麻醉下手术498例,传统全身麻醉下手术525例。与传统全身麻醉相比,术中唤醒麻醉下手术切除语言功能区胶质瘤的平均切除范围、术后恶心呕吐情况、术后3月KPS评分更具优势,术中出血量更多,但手术时间、术中癫痫发作、全切率、住院时间、并发症、语言肢体功能障碍、术后1月KPS评分无差异。结论:术中唤醒麻醉下手术治疗语言功能区胶质瘤较传统全身麻醉下手术病灶清除率更高,术后恶心呕吐发生情况更少,术后3月KPS评分更高,但术中出血量更多。Objective:To investigate the efficacy and safety of removal glioma surgery in eloquent area under awake anes⁃thesia and general anesthesia.Methods:The data were searched from the databases including PubMed,EMbase,Cochrane Library,CNKI,VIP,Wanfang and so on,for the study of comparing awake anesthesia with general anesthesia for surgical removal of glioma in eloquent area during the span of the establishment of those databases to February 2020,and then making a meta-analysis by employing Rev Man 5.3 software.Results:A total of 13 studies were included,including 4 prospective cohort studies and 9 retrospective case-control studies.Among the 1023 subjects,498 cases underwent awake anesthesia and 525 cases were under general anesthesia.Meta-analysis results suggested that there was no significant difference in the operation time,intraoperative seizures,total resection rate,hospital stay,complications,language limb dysfunction,and KPS score at 1 month after surgery between the two groups.However,surgical resection under awake anesthesia for gliomas in eloquent area could obtain larger average resection range,lower incidence of post⁃operative nausea and vomiting,higher postoperative KPS score at 3 months,and more bleeding during operation compared with general anesthesia. Conclusion : Surgical treatment of gliomas in eloquent area under awake anesthesia haslarger average resection range,lower incidence of postoperative nausea and vomiting,and higher postoperative KPSscore at 3 months after operation,but more bleeding during operation compared with general anesthesia.

关 键 词：胶质瘤 术中唤醒麻醉 META分析 

分 类 号：R739.41[医药卫生—肿瘤]