关键词: 体外循环, 心脏手术, 肺保护, 七氟醚, Meta分析

Abstract: Abstract: Objective To assess the lung protection effect of sevoflurane on adult cardiac surgery during cardiopulmonary bypass (CPB) using Meta-analysis. Methods The databases of Cochrane library, Embase, PubMed, Google scholar, CNKI, Wanfang and Weipu were comprehensively searched by computer up to December 2017 to obtain the published literature on randomised controlled trials (RCT) of sevoflurane for lung protection under CPB. Key words included extracorporeal circulation, cardiac surgery, pulmonary protection, sevoflurane and Meta-analysis. And then a separate quality assessment and data extraction for the selected literatures were carried out by two researchers. The Meta-analysis was performed via statistical software RevMan5.3. Results Eleven RCT literatures and 440 patients in total were selected in this study, in which, 220 cases were for the sevoflurane group and 220 cases were for the total intravenous anesthesia (TIVA) group. The analysis results showed that the application of sevoflurane could significantly reduce the levels of IL-6 (P=0.005) and IL-8 (P=0.01) in the blood, and decrease postoperative tracheal intubation time in CPB group compared with those of TIVA group (P＜0.001). However, there were no statistical differences in the level of tumor necrosis factor-α (TNF- α) (P=0.19), the alveolar-arterial differences for oxygen［P（A-a）O2 ］(P=0.68) and the oxygenation index OI between two groups (P=0.31). Conclusion The application of sevoflurane during CPB could effectively reduce the levels of some inflammatory factors in blood and decrease the postoperative tracheal intubation time. However, there is no adequate evidence to prove the definite lung protection effect of sevoflurane on CPB.

Key words: extracorporeal circulation, cardiac surgery, pulmonary protection, sevoflurane, Meta-analysis