七氟醚在心脏外科手术期间对心肌的保护作用：meta分析
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Meta-analysis of protective effect of sevoflurane on myocardium during cardiac surgery
背景与目的
本研究旨在探讨七氟醚麻醉对心脏外科手术的影响，为临床麻醉实践提供依据。
方 法
从PubMed和EMBASE数据库检索七氟醚麻醉对心脏手术心肌保护作用的文献，截止时间为2012年3月。根据Jadad评分对纳入的随机对照试验评估和筛选。最后，使用RevMan5.0软件进行meta分析。
结 果
在本研究中，共有17篇符合纳入标准的文章，所有的文章都是以英语撰写且为国外的研究。每一篇文章在Jadad评分在3分以上。与全凭静脉麻醉组相比，术后12h CO和CI患者已经在七氟醚麻醉组明显提高；术后24 h cTnI在七氟醚麻醉组浓度，以及辅助呼吸时间和术后ICU停留时间降低。两组患者住院时间无显著差异，术后应用血管活性药物在七氟醚麻醉组术后均少于静脉全麻组。两组患者术后房颤、心绞痛复发率、术后死亡率无显著差异。
结 论
在心脏外科手术中，七氟醚能更好地保护心肌。
原始文献摘要
BACKGROUND:
This study aims to evaluate the effect of sevoflurane anesthesia on myocardium in cardiac surgery and provide evidence for clinicalanesthesia practice.
MATERIALS AND METHODS:
Literature about the protective effect of sevoflurane anesthesia on myocardium in cardiac surgery published before March, 2012 was retrieved from the database of PubMed and EMBASE. The quality of inclusive randomized controlled trials was evaluated and screened according to the Jadad scale. Finally, meta-analysis was performed by using the RevMan5.0 software.
RESULTS:
In this research, there were totally 17 articles in accordance with the inclusive criteria and all of them were in English with the study sites being abroad. Each article was more than 3 points in Jadad scale. Compared with total intravenous anesthesia group, postoperative 12h CO and CI of patients have been significantly improved in the sevoflurane anesthesia group; and concentration of postoperative 24 h cTnI in the sevofluraneanesthesia group has been reduced, as well as assisted respiratory time and ICU stay after operation. There is no significant difference in hospitalization stay between both groups; postoperative usage of vasoactive drugs in sevoflurane anesthesia group is less than in total intravenousanesthesia group. There is no significant difference in postoperative appearance of atrial fibrillation, recurrence rate of angina pectoris and mortality of patients after operation between both groups.
CONCLUSIONS:
Sevoflurane can better protect myocardium in the cardiac surgery.
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