目的 评价硬膜外麻醉合用丙泊酚用于腹腔镜胆囊切除术的可行性。方法 择期行腹腔镜胆囊切除术患者850例，经T 9～10椎间隙行硬脊膜外腔穿刺置管，给予常规剂量的2%利多卡因或0.75%布比卡因，气腹前静脉注射丙泊酚1～2 mg/kg,直至患者意识消失，继以10 mg/(kg·h)维持麻醉深度。结果 全组850例患者术中麻醉效果好，腹肌松弛，意识消失后避免了气腹引起的牵扯反射，停止使用丙泊酚10 min左右时间，大部分患者即恢复呼唤反应。 结论 硬膜外麻醉合用丙泊酚用于腹腔镜胆囊切除术是一种效果很好的临床麻醉方法。
ObjectivesTo systematically review the efficacy of resorbable membrane and non-resorbable membrane in dental implant to guide bone regeneration.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, VIP, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of resorbable membrane and non-resorbable membrane in dental implant to guide bone regeneration from inception to February 20th, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 22 RCTs involving 1 995 patients were included. The results of meta-analysis showed that: the resorbable membrane group was superior to non-resorbable membrane group in terms of repair success (RR=1.21, 95%CI 1.17 to 1.26, P<0.000 01), the bone thickness (MD=0.40, 95%CI 0.36 to 0.43, P<0.000 01), bone graft thickness(MD=0.40, 95%CI 0.35 to 0.46, P<0.000 01), patient satisfaction (RR=1.19, 95%CI 1.04 to 1.36, P=0.009), histological evaluation in bone contact (MD=4.82, 95%CI 0.14 to 9.50, P=0.04) and the total mineralized tissue (MD=3.73, 95%CI 0.32 to 7.14, P=0.03). They also had lower adverse reaction rate(RR=0.28, 95%CI 0.20 to 0.39, P<0.000 01) and changes of bone defect width from preoperative to 6 months postoperatively (MD=−0.62, 95%CI −0.93 to −0.31, P<0.000 01) with statistically significant differences. However, there was no significant difference in histological evaluation of non-mineralized tissue(MD=−2.48, 95%CI −5.81 to 0.85, P=0.14) between two groups.ConclusionsCurrent evidence shows that the resorbable membrane has better repairing effects, for which helps to promote the development of bone and bone graft, reduce the incidence of adverse reactions, which has good safety and effectiveness. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.