| Objective: Meta analysis was conducted by searching all the relevant randomized controlled trials to objectively evaluate the effect of neuraxial anesthesia and general anesthesia on the incidence of thrombosis after hip arthroplasty,so as to provide some evidence-based bases and suggestions for clinical practice.Methods: We searched Pubmed,Embase,The Cochrane Library,CNKI,Wanfang,Sinomed and other related databases for papers.Randomized controlled trials(RCTs)for studies concerning deep vein thrombosis after hip arthroplasty with different anesthetia methods that met the included standard were collected.Quality evaluation and data extraction were carried out for the included literature.Rev Man 5.3 software provided by Cochrane Collaboration was used for statistical analysis.Results: 245 related articles were searched and 22 RCTs meeting the criteria were finally included.Meta-analysis showed that: Compared with general anesthesia,neuraxial anesthesia could reduce the incidence of thrombosis after hip arthroplasty [OR=0.31,95%CI(0.24~0.40)P<0.01],the difference was statistically significant.Meta subgroup analysis showed that: All three types of neuraxial anesthesia including epidural anesthesia,spinal anesthesia as well as combined spinal-epidural could reduce the formation of thrombosis after hip joint replacement[OR=0.26,95%CI(0.20~0.35)P<0.01],the difference was statistically significant;At the same time,neuraxial anesthesia can reduce the incidence of pulmonary embolism after hip arthroplasty without anticoagulants[OR=0.23,95%CI(0.10~0.49)P<0.01],and the difference was statistically significant.Conclusion: Compared with general anesthesia,neuraxial anesthesia can reduce the incidence of thrombosis after hip arthroplasty,and has no significant correlation with the way of neuraxial anesthesia.Therefore,for the hip surgery in high-risk populations with thrombosis,neuraxial anesthesia is recommended to reduce the incidence of postoperative thrombosis and pulmonary embolism. |
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