椎旁神经阻滞对胸部微创术后患者疼痛缓解及快速康复效果的meta分析  

Meta-analysis of the effect of paravertebral nerve block on pain relief and rapid recovery of patients after minimally invasive thoracic surgery

作　　者：李杰[1] 张海平[1] 李德生[1] 孙清超[1] 张力为[1] LI Jie;ZHANG Haiping;LI Desheng;SUN Qinchao;ZHANG Liwei(Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院胸外科,新疆乌鲁木齐830054

出　　处：《中国医药科学》2025年第5期163-167,共5页China Medicine And Pharmacy

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(SKL-HIDCA-2020-SG5);新疆医科大学第一附属医院卓越人才及创新团队培养项目。

摘　　要：目的研究椎旁神经阻滞对胸部微创手术患者术后疼痛缓解及快速康复的效果。方法计算机检索Web of science、PubMed、Embase、The Cochrane library、Cinomed、中国知网、万方数据库、维普期刊数据库等,对符合纳入标准的研究进行资料提取,分为椎旁组和对照组。观察指标:术后视觉模拟评分法(VAS)疼痛评分、术后镇痛药物使用、镇痛相关不良反应、术后相关并发症、住院天数。结果纳入共13篇文献,1014例患者,试验组中术后4 h疼痛评分显著降低(MD=-0.88,95%CI:-1.14~-0.61,P<0.01)、术后12 h疼痛评分显著降低(MD=-1.11,95%CI:-1.53~-0.69,P<0.01)、术后24 h疼痛评分显著降低(MD=-0.67,95%CI:-1.14~-0.21,P<0.01);镇痛相关不良反应率发生显著降低(RR=0.51,95%CI:0.36~0.72,P<0.01);术后相关并发症发生显著减少(RR=0.53,95%CI:0.32~0.87,P<0.05);住院天数显著缩短(MD=-2.12,95%CI:-2.32~-1.92,P<0.01)。结论椎旁神经阻滞是相对有效且安全的胸部微创术后镇痛方式,满足术后快速康复的需求。Objective To study the effect of paravertebral nerve block on postoperative pain relief and rapid recovery in patients undergoing minimally invasive thoracic surgery.Methods Computerized search of Web of science,Clinical trail,PubMed,Embase,The Cochrane library,CNKI,Wanfang database,and VIP database,etc.,to extract the data of the studies that met the inclusion criteria,and divided them into the paravertebral group and the control group,and observe the indexes:postoperative visual analogue scale(VAS)pain score,postoperative analgesic drug use,analgesic-related adverse reactions,postoperative-related complications,and hospitalization days.Results A total of 13 articles and 1014 patients were included.In the experimental group,the postoperative pain scores were significantly reduced at 4 h(MD=-0.88,95%CI:-1.14--0.61,P<0.01),12 h(MD=-1.11,95%CI:-1.53--0.69,P<0.01),and 24 h(MD=-0.67,95%CI:-1.14--0.21,P<0.01).The incidence of analgesia-related adverse reaction rate was signif icantly reduced(RR=0.51,95%CI:0.36-0.72,P<0.01),the incidence of postoperative complications was significantly reduced(RR=0.53,95%CI:0.32-0.87,P<0.05),and the number of hospitalization days was significantly reduced(MD=-2.12,95%CI:-2.32--1.92,P<0.01).Conclusion Paravertebral nerve block is a relatively effective and safe form of analgesia after minimally invasive thoracic surgery,meeting the need for rapid postoperative recovery.

关 键 词：胸部微创手术 椎旁神经阻滞 加速康复外科 随机对照试验 META分析 

分 类 号：R614[医药卫生—麻醉学]