采用Meta分析比较七氟烷和丙泊酚在肝切除术中的麻醉效果。

系统检索Cochrane图书馆、Pubmed、Embase、中国知网、维普、万方数据库，检索时间为建库至2022年3月。中文检索词：七氟烷、丙泊酚、肝切除、临床随机对照试验等。英文检索词：Sevoflurane、propofol、hepatectomy、randomized controlled trial。检索关于七氟烷与丙泊酚在肝切除术中麻醉效果的RCT文献。七氟烷组以七氟烷作为麻醉用药联合芬太尼等其他镇痛药，丙泊酚组以丙泊酚为麻醉用药联合芬太尼等其他镇痛药，采用RevMan 5.4软件进行Meta分析，比较两组麻醉效果。

共纳入13项RCT，共923例患者。其中七氟烷组460例，丙泊酚组463例。Meta分析显示，七氟烷组麻醉插管后的平均动脉压明显低于丙泊酚组（MD=-5.17，P<0.05）；术后ALT、AST、TB水平明显低于丙泊酚组（MD=-52.70，-41.18，-9.19；P<0.05）；术后IL-6、IL-10、TNF-α水平明显低于丙泊酚组（MD=-6.32，-10.98，-4.25；P<0.05）；术后自主呼吸恢复时间、睁眼时间明显早于丙泊酚组（MD=-5.54，-12.45；P<0.05）；术后疼痛视觉模拟评分明显低于丙泊酚组（SMD=-1.19，P<0.05）；而两组术后拔管时间差异无统计学意义（MD=-12.15，P=0.05）。

相较于丙泊酚，肝切除术采用七氟烷进行麻醉，可抑制患者术后血浆炎症因子分泌，促进肝功能恢复，有利于术后麻醉苏醒，且具有良好的镇痛效果，临床上获益明显。

To compare the anesthetic effects of sevoflurane and propofol in hepatectomy by using Meta-analysis.

Randomized controlled trials (RCTs) regarding anesthetic effects of sevoflurane and propofol in hepatectomy were systematically searched from Cochrane Library, PubMed, Embase, CNKI, Chongqing VIP and Wanfang databases from the inception date to March 2022 by using the keywords of sevoflurane, propofol, hepatectomy and RCT in both English and Chinese. In the sevoflurane group, sevoflurane combined with fentanyl and other analgesics was given, and propofol in combination with fentanyl and other analgesics was delivered in the propofol group. Meta-analysis was conducted by RevMan 5.4 software. The anesthetic effects were compared between two groups.

13 RCTs consisting of 923 patients were enrolled. 460 patients were assigned in the sevoflurane group and 463 cases in the propofol group. Meta-analysis showed that the average arterial pressure after anesthesia and tracheal intubation in the sevoflurane group was significantly lower than that in the propofol group (MD=-5.17, P<0.05). Postoperative levels of ALT, AST and TB in the sevoflurane group were significantly lower than those in the propofol group (MD=-52.70, -41.18, -9.19; P<0.05). Postoperative levels of IL-6,IL-10 and TNF-α in the sevoflurane group were significantly lower compared with those in the propofol group (MD=-6.32, -10.98, -4.25; P<0.05). In the sevoflurane group, the recovery time of spontaneous breathing and the time of eye opening after operation were significantly shorter than those in the propofol group (MD=-5.54, -12.45; P<0.05). Postoperative visual analogue scale (VAS) score in the sevoflurane group was significantly lower than that in the propofol group (SMD=-1.19, P<0.05). There was no significant difference in extubation time between two groups (MD=-12.15, P=0.05).

Compared with propofol, sevoflurane anesthesia in hepatectomy can suppress postoperative secretion of plasma inflammatory cytokines, accelerate the recovery of liver function, contribute to postoperative recovery of anesthesia, yield favorable analgesic effect and bring clinical benefits.