全身麻醉复合硬膜外麻醉对肿瘤患者预后影响的Meta分析

Meta analysis of the effect of general anesthesia combined with epidural anesthesia on prognosis of patients with tumor

目的:分析全身麻醉复合硬膜外麻醉对肿瘤患者预后影响的荟萃研究。方法:采用计算机检索方法对中国知网数据库、中国超星数据库、中国万方数据库等进行检索,检索研究主题的随机对照试验,对相关数据进行整合,做好荟萃分析。结果:最终纳入13篇,涉及患者1 862例。分析显示,患者术后出现转移和复发率之间差异无统计学意义(P>0.05);高龄组患者和短期随访组的患者对两种麻醉方式之后负荷转移率之间差异有统计学意义(P<0.05)。结论:硬膜外麻醉联合全身麻醉和单纯的麻醉相比不能有效降低癌症患者术后肿瘤复发转移率,对于年龄超过64岁的患者以及随访时间2年以下的患者,远期的复发转移率相对于单纯麻醉来说更低,而对于直肠癌患者和术前无转移的患者来说,其预后并没有明显的改善。

Objective:To analyze meta analysis of the effect of general anesthesia combined with epidural anesthesia on prognosis of patients with tumor.Methods:Using the computer search method to search the CNKI database,the Chinese superstar database,the Chinese Wanfang database to retrieve,searched the subject of randomized controlled trials and integrated relevant data,made Meta analysis.Results:Finally,13articles were included,involving a total of1862patients.The analysis showed that there was no significant difference between the patients with metastasis and recurrence(P>0.05).There were significant differences in the rate of load transfer between the two groups of elderly patients and those in the short-term follow-up group(P<0.05).Conclusion:Epidural anesthesia combined with general anesthesia and anesthesia alone can not effectively reduce the recurrence rate ofcancer patients after surgery.For patients over the age of64years and those who were followed up for a period of less than2years,the long-term recurrence rate was lower than that of simple anesthesia.There was no significant improvement in the prognosis of patients with rectal cancer and those without metastasis before surgery.