Ⅱ型胸神经阻滞对乳腺癌患者术后免疫功能影响的Meta分析  

Effects of Pectoral Nerve Block TypeⅡon Postoperative Immune Function in Patients with Breast Cancer:A Meta-Analysis

作　　者：徐宁[1] 王姝衡 刘路路 Xu Ning;Wang Shuheng;Liu Lulu(Department of Anesthesiology,Weihai Central Hospital Affiliated to Qingdao University,Weihai 264400,China;Operating Room,Weihai Central Hospital Affiliated to Qingdao University,Weihai 264400,China;Department of Respiratory and Critical Care Medicine,Weihai Central Hospital Affiliated to Qingdao University,Weihai 264400,China)

机构地区：[1]青岛大学附属威海市中心医院麻醉科,山东威海264400 [2]青岛大学附属威海市中心医院手术室,山东威海264400 [3]青岛大学附属威海市中心医院呼吸与危重症医学科,山东威海264400

出　　处：《巴楚医学》2024年第1期104-110,共7页Bachu Medical Journal

基　　金：山东省医学会临床科研专项资金项目(No:YXH2022ZX02104)。

摘　　要：目的:系统评价超声引导下Ⅱ型胸神经阻滞(UPB)联合全麻对乳腺癌患者术后免疫功能的影响。方法:系统检索PubMed、Embase、Cochrane Library、Web of Science、万方、知网和维普数据库,限定检索时间截止至2022年10月。应用Revman 5.4、Stata 15.1软件进行Meta分析。结果:共纳入6篇符合纳入标准的文献,共639例患者。Meta分析结果显示:与单纯全麻相比,UPB联合全麻患者术后CD3+(MD=3.86,95%CI:2.73,4.99)、CD4^(+)(MD=2.28,95%CI:1.19,3.36)、CD4^(+)/CD8^(+)(MD=0.16,95%CI:0.12,0.20)水平升高;术后CD8^(+)(MD=-1.34,95%CI:-1.93,-0.76)水平、术中瑞芬太尼用量(SMD=-1.72,95%CI:-2.00,-1.44)以及术后24 h的视觉模拟评分(MD=-0.77,95%CI:-1.49,-0.04)降低。结论:UPB联合全麻能增强乳腺癌患者术后免疫功能,减少术中瑞芬太尼用量,术后镇痛效果更好。Objective:To systematically evaluate the effect of ultrasound-guided pectoral nerve block typeⅡ(UPB)combined with general anesthesia(GA)on postoperative immune function in patients with breast cancer.Methods:A systematic search of PubMed,Embase,Cochrane Library,Web of Science,Wanfang,CKNI and VIP databases was conducted,with a limited search period ending in October 2022.Revman 5.4 and Stata 15.1 softwares were used to conduct the meta-analysis.Results:A total of 6 papers meeting the inclusion criteria were included,encompassing 639 patients.The results of meta-analysis showed that postoperative levels of CD3+(MD=3.86,95%CI:2.73,4.99),CD4^(+)(MD=2.28,95%CI:1.19,3.36),and CD4^(+)/CD8^(+)(MD=0.16,95%CI:0.12,0.20)in patients received UPB combined with GA were higher than those in patients with GA alone.Postoperative level of CD8^(+)(MD=-1.34,95%CI:-1.93,-0.76),intraoperative remifentanil consumption(SMD=-1.72,95%CI:-2.00,-1.44),and visual analogue score(MD=-0.77,95%CI:-1.49,-0.04)at 24 h after surgery were lower in patients received UPB combined with GA when compared to those with GA alone.Conclusion:UPB combined with GA can enhance the postoperative immune function,reduce intraoperative remifentanil consumption,and provide better postoperative analgesia in patients with breast cancer.

关 键 词：Ⅱ型胸神经阻滞 全麻 乳腺癌 免疫功能 META分析 

分 类 号：R614[医药卫生—麻醉学]