不同吸痰时机对全麻患者气管导管拔除效果比较的Meta分析  

Meta analysis of the effect of different endotracheal suction timing on endotracheal extubation in patients under general anesthesia

作　　者：王秀丽 刘晓黎 孙亮[1] 何苗[1] WANG Xiuli;LIU Xiaoli;SUN Liang;HE Miao(Department of Anesthesiology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院麻醉科,北京100044

出　　处：《麻醉安全与质控》2024年第5期254-259,共6页Perioperative Safety and Quality Assurance

基　　金：北京大学医学部循证护理专项基金(XZJJ-2024-3)。

摘　　要：目的比较不同吸痰时机对成人患者气管导管拔除效果的影响。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library及中国知网(CNKI)、万方数据库、维普数据库及中国生物医学文献数据库(SinoMed)中有关不同吸痰时机对全麻患者气管导管拔除效果的随机对照试验。检索日期从2000年1月至2022年10月。根据纳入、排除标准对文献进行筛选并提取,使用Cochrane评价工具进行文献质量评价,应用RevMan5.3软件进行Meta分析。本研究最终纳入9项随机对照试验,共包括1090例患者,对照组542例,试验组548例,文献质量中等。结果Meta分析结果显示:与对照组比较,试验组拔管后血压[MD=-4.34,95%CI(-5.25~-3.42),P<0.01]、心率[MD=-6.26,95%CI(-6.99~-5.54),P<0.01]较平稳,呛咳发生[RR=0.40,95%CI(0.23~0.69),P<0.01]较低,患者拔管后的脉搏血氧饱和度(SpO 2)高于对照组[MD=4.26,95%CI(3.52~5.00),P<0.01],差异有统计学意义。结论麻醉下吸痰、清醒后拔管在维持患者心率、血压的稳定,减少呛咳及缺氧的发生方面优于清醒后吸痰拔管。Objective To compare the effects of different endotracheal suction timing on endotracheal extubation in patients under general anesthesia.Methods The database of the PubMed,Web of Science,EMBASE,Cochrane Library CNKI,Wanfang Data,VIP database and SinoMed were screened for randomized controlled trials on the effects of different suction timing on endotracheal extubation in patients under general anesthesia.The Meta-analysis was performed using RevMan5.3 software and the retrieval date from January 2000 to October 2022.The Cochrane quality evaluation tool was used to evaluate the literature quality.A total of 1090 patients were included in 9 randomized controlled trials,which were divided into the control group(n=542)and the experimental group(n=548).Results Meta-analysis results showed that,compared with the control group,patients in the experimental group had more stable post-extubation blood pressure[MD=-4.34,95%CI(-5.25,-3.42),P<0.01]and heart rate[MD=-6.26,95%CI(-6.99,-5.54),P<0.01];the incidence of cough[RR=0.40,95%CI(0.23-0.69),P<0.01]was low;the oxygen saturation after extubation was higher,the difference was statistically significant[MD=4.26,95%CI(3.52-5.00),P<0.01].Conclusion Endotracheal suction under deep anesthesia are better than endotracheal suction after waking in reducing the fluctuation of heart rate and blood pressure,and reducing the occurrence of cough and hypoxia.

关 键 词：吸痰 全身麻醉 气管导管 拔管 META分析 系统评价 

分 类 号：R614.2[医药卫生—麻醉学]