丙泊酚麻醉对胸腹部肿瘤手术患者肺功能、肺部感染及炎症因子影响的meta分析

Meta-analysis on the effects of propofol anesthesia on pulmonary function, pulmonary infection and inflammatory factors in patients undergoing thoracic and abdominal tumor surgery

目的系统评价丙泊酚对胸腹部肿瘤手术患者术后肺功能、肺部感染及炎症因子的影响。方法计算机检索知网、万方、维普、PubMed、Cochrane Library以及Web of Science数据库,搜集关于丙泊酚麻醉对胸腹部肿瘤患者术后影响的随机对照试验(RCTs),检索时限均为建库至2022年10月,采用RevMan 5.4软件对结局指标进行meta分析。结果最终纳入9项研究,共计974例患者。meta分析结果显示,丙泊酚组患者术后血清细胞促炎因子白介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)及核因子-κB(NK-κB)明显低于对照组,抗炎因子IL-10明显高于对照组;但丙泊酚对肺功能的影响较小。同时,丙泊酚组术后肺部感染率明显低于对照组。结论胸腹部肿瘤手术应用丙泊酚麻醉能够抑制机体炎症因子释放,降低肺部感染率,改善患者预后情况,但对肺功能恢复情况影响不大。

Objective To systematically assess the effects of propofol on pulmonary function,pulmonary infection and inflammatory factors in patients undergoing thoracic and abdominal tumor surgery.Methods Randomized controlled trials(RCTs)on the effects of propofol anesthesia on patients undergoing thoracic and abdominal tumor surgery included in China National Knowledge Internet,Wanfang,VIP,PubMed,Cochrane Library,and Web of Science databases from database establishment to October 2022 were retrieved by computer,and the retrieved RCTs were subjected to meta-analysis on outcome indices by RevMan 5.4 software.Results A total of 9 RCTs with 974 patients were included in this study.The results of meta-analysis showed that the postoperative levels of serum proinflammatory factors including interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and nuclear factor-κB(NK-κB)were si gnificantly lower,while anti-inflammatory factor interleukin-10(IL-10)was significantly higher in patients in the propofol group than in the control group.The propofol had minor impact on lung function.Besides,the rate of postoperative pulmonary infection in the propofol group was significantly lower than that in the control group.Conclusion Propofol anesthesia in thoracic and abdominal tumor surgery can inhibit the release of inflammatory factors,reduce the rate of pulmonary infection,and improve the prognosis of patients,but with mino r effect on the recovery of pulmonary function.