【罂粟摘要】不同麻醉方法对妊娠合并肺动脉高压患者行剖宫产术母婴预后影响的比较：一项Meta分析
不同麻醉方法对妊娠合并肺动脉高压患者行剖宫产术母婴预后影响的比较：一项Meta分析
贵州医科大学 麻醉与心脏电生理课题组
翻译：吴学艳 编辑：潘志军 审校：曹莹
目的
探讨不同麻醉方法对妊娠合并肺动脉高压(PAH)患者母婴预后的影响。
方法
检索PubMed、Excerpta Medica Database (EMBASE)、Cochrane Library、Web of Science、中国知网(CNKI)、万方、QVIP等数据库，探讨全身麻醉(GA)和局部麻醉(LA)对妊娠PAH患者的影响。结果以加权平均差(WMD)或风险比(RR)表示，可信区间(CIs)为95%，发表偏倚通过Begg’s试验进行评估。
结果
研究共纳入18篇文献，其中LA患者628例，GA患者481例。LA组术后血氧饱和度(WMD=−4.040,95%CI：−5.505~2.576)，产死亡率(RR=0.507, 95%CI：0.300~0.858)均低于GA组；LA组术后收缩压(WMD=15.647, 95%CI：13.294~18.000)和舒张压(WMD=6.758, 95%CI：5.715~7.802)均高于GA组；LA组机械通气时长(WMD=−4.112,95%CI:−4.655~−3.569)、ICU住院时长(WMD=−4.176,95%CI:−4.523~−3.828)、总住院时长(WMD=−7.289, 95%CI:−7.799~6.779)均短于GA组，P值均<0.05。
LA组在术后血氧饱和度、术后收缩压、术后舒张压、机械通气时长、ICU住院时长、总住院时长及产妇死亡率均优于GA组。
原始文献来源：Ming Y, Wu Z, Wu Z, et al. Effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension: a meta-analysis[J].Arch Gynecol Obstet. 2021 Oct 14. DOI:10.1007/s 00404-021-06274-6.
英文原文👇
Effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension: a meta-analysis
Abstract
Purpose: To investigate the effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension (PAH).
Methods: We searched PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang and QVIP for investigating the effects of general anesthesia (GA) and local anesthesia (LA) in pregnant patients with PAH. Results were expressed as weighted mean difference (WMD) or risk ratio (RR) with 95% confidence intervals (CIs). Publication bias was assessed by the Begg's test.
Results: Totally, 18 articles containing 628 LA and 481 GA patients were involved in our study. The postoperative blood oxygen saturation (WMD = - 4.040, 95%CI: - 5.505 to - 2.576) and maternal mortality rate (RR = 0.507, 95%CI: 0.300-0.858) were lower in LA group than those in GA group. The postoperative systolic blood pressure (WMD = 15.647, 95%CI: 13.294-18.000) and postoperative diastolic blood pressure (WMD = 6.758, 95%CI: 5.715-7.802) were high in LA group compared with those in GA group. The mechanical ventilation time (WMD = - 4.112, 95%CI: - 4.655 to - 3.569), ICU admission time (WMD = - 4.176, 95%CI: - 4.523 to - 3.828), length of stay (WMD = -7.289, 95%CI: -7.799-6.779) were shorter in LA group than those in GA group. All P values were < 0.05.
Conclusions: LA is superior to GA in regards to the postoperative blood oxygen saturation, the postoperative systolic blood pressure, postoperative diastolic blood pressure, the mechanical ventilation time, ICU admission time, length of stay and the maternal mortality rate.