丙泊酚和七氟醚对乳腺癌手术后生存率和复发率影响的Meta分析

目的 评价丙泊酚和七氟醚对乳腺癌手术后五年生存率和复发率的影响。
方法 计算机检索PubMed、Embase、Cochrane Library、Web of Science、维普、万方和知网数据库，收集关于丙泊酚和七氟醚对乳腺癌手术预后影响的随机对照试验和回顾性研究，检索时间为建库至2021年5月28日。按照纳入和排除标准进行文献筛选、数据提取和质量评价，采用RevMan 5.4统计软件进行Meta分析。
结果 共纳入8篇研究，患者10 662例，其中丙泊酚组4 210例，七氟醚组6 452例。Meta分析结果显示，与七氟醚组比较，丙泊酚组乳腺癌术后五年生存率明显升高（OR=1.82，95%CI 1.08～3.04，P=0.02）。两组术后的乳腺癌复发率（OR=0.71，95%CI 0.47～1.06，P=0.10）差异无统计学意义。
结论 与七氟醚麻醉比较,丙泊酚麻醉明显升高乳腺癌术后五年生存率，但对乳腺癌术后复发率的影响无明显差异。因受诸多因素影响，上述结论仍需更多大样本双盲随机对照试验予以验证。

Effects of survival rate and recurrence rate of propofol and sevoflurane on prognosis of breast cancer: a meta-analysis

Ojective To evaluate the survival rate and recurrence rate of propofol and sevoflurane on the prognosis of breast cancer respectively.
Methods The relevant literatures in PubMed, Embase, Cochrane Library, Web of science, VIP, Wanfang Data and CNKI databases were searched. The randomized controlled trials and retrospective studies on the effects of propofol and sevoflurane on the prognosis of breast cancer were selected. The retrieval time was from the establishment of the database to May 28, 2021. Literature screening, data extraction and assessment of the risk bias were undertaken, and then meta-analysis was performed using the software Review Manager 5.4.
Results Eight studies involving 10 662 patients were included, 4 210 in the propofol group and 6 452 in the sevofluane group. The Meta-analysis showed that, compared with sevofluane group, propofol group had a higher 5-year survival rate after breast cancer (OR = 1.82, 95% CI 1.08-3.04, P = 0.02). There was no significant difference in the recurrence rate of breast cancer between two groups (OR = 0.71, 95% CI 0.47-1.06, P = 0.10).
Conclusion General anesthetics using propofol had a higher 5-year survival rate than using sevofluane, but the selection of the two anesthetics had little impact on the recurrence rate of breast cancer after surgery. Due to many factors, the conclusions above still need to be verified by more large sample double-blind randomized controlled trials.