可视双腔支气管导管在胸科手术中应用效果评价Meta分析

A Meta-analysis about the effect of Visual double-lumen bronchial tube in thoracic surgery

目的通过Meta-分析来评价可视双腔支气管导管在胸科手术中应用效果,以提高麻醉的安全性和有效性。方法计算机检索Pubmed,Cochrane图书馆,Science,万方,CNKI,维普,CBM等数据库检索相关资源,检索时间截止到2020年7月,手工检索并辅以追溯文献的方法寻找相关参考文献。收集可视双腔支气管导管与普通双腔支气管导管的随机对照试验,由两位研究员独立地完成文献质量评价后,将有效数据提取后采用RevMan5.3软件进行评价。结果纳入13篇文献,共计938例患者,其中观察组466例,对照组472例。Meta分析结果显示:与对照组(DLT组)相比,观察组(VDLT组)插管定位时间较短(95%CI:-141.17~-52.54;P<0.0001),首次定位成功率高(95%CI:0.05~0.61;P=0.02),导管重新定位率发生率低(95%CI:0.34~0.83;P=0.006),术后咽痛有差别,有统计学意义(95%CI:0.29~094;P<0.05);术后声嘶(95%CI:0.53~1.09;P>0.05)、气道损伤(95%CI:0.15~4.17;P>0.05)均无差别,无统计学意义。结论可视双腔支气管导管在胸科手术中插管定位快速准确,但具有一定的临床局限性,值得临床进一步探索研究。

Objective To perform a Meta-analysis to evaluate the effect of Visual double-lumen bronchial catheter on thoracic surgery,and to improve the safety and effectiveness of anesthesia.Methods We performed a meta-analysis of published studies.The data from Pubmed,Science,CNKI,Wanfang data,Viper,CBmdisc were computerized retrieved.The retrieval time was up to July 2020.And relevant references were searched by manual retrieval and retrospective method.All randomized controlled trial results about visual double-lumen bronchial tubes and conventional double-lumen bronchial tubes were collected.The literature quality evaluation was independently completed by two researchers,then the valid data were extracted and evaluated by Rev Man 5.3 software.Results 13 studies met the selection criteria and 938 cases were included into this study.Among them,466 cases were treated with visual double-lumen bronchial tube and divided into observation group,while 472 cases were treated with conventional double-lumen bronchial tube and were divided into control group.Meta analyses showed that the observation group(VDLT group)had shorted intubation positioning time compared with that of the control group(DLT group)(95%CI:-141.17~-52.54;P<0.0001).In the observation group,the success rate of the first intubation location was higher(95%CI:0.05~0.61,P=0.02),the rate of catheter repositioning is lower(95%CI:0.34~0.83;P=0.06),and postoperative pharyngeal pain was different from control group,the difference had statistical significance(95%CI:0.29~094;P<0.05),The postoperative hearing,airway damage has no difference and no statistical significance between two groups.Conclusion Visual double-lumen tubes is fast and accurate in intubation localization in thoracic surgery,although it has certain clinical limitations,it is still worthy of further clinical research.