目的：探讨全身麻醉（GA）和区域麻醉（RA）对腰椎手术患者发生术后尿潴留（POUR）的影响，以判断麻醉方法是否为影响腰椎手术后POUR发生的影响因素。方法：检索已发表的随机对照研究（RCT）文献，比较采用GA和RA行腰椎手术患者POUR的发生风险；应用既定的文献检索策略在数据库中检索相关文献，经筛选后提取纳入文献的信息；采用改良的Jadad评分量表评估文献的质量；采用软件Review Manager 5.0对两种麻醉方法下腰椎手术患者POUR发生的风险比（RR）进行汇总分析，同时行异质性分析和发表偏倚分析。结果：共有12个RCT筛选后纳入，总样本量为900；汇总结果显示，RA相对于GA的RR为1.18，95%置信区间为0.77～1.81；异质性检验结果显示，χ²=14.63，P=0.15，I²=0.32，漏斗图显示未见明确发表偏倚。结论：两种麻醉方法对腰椎手术患者POUR发生的影响没有显著差异，麻醉方法不是影响腰椎手术POUR的因素。

[1] HOFFMANN J,TULLOCH A G S.Postoperative urinary retention:anesthetic and perioperative considerations[J].Anesthesiology,2009,110(5):1139-1157.
[2] LEE S,KIM C H,CHUNG C K,et al.Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis[J].Spine J,2017,17(4):469-477.
[3] MISSIOS S,BEKELIS K.Spine surgery and malpractice liability in the United States[J].Spine J,2015,15(7):1602-1608.
[4] WEINSTEIN J N,LURIE J D,OLSON P,et al.United States trends and regional variations in lumbar spine surgery:1992-2003[J].Spine,2006,31(23):2707.
[5] MISSIOS S,BEKELIS K.Hospitalization cost after spine surgery in the United States of America[J].J Clin Neurosci,2015,22(10):1632-1637.
[6] DE ROJAS J O,SYRE P,WELCH W C.Regional anesthesia versus general anesthesia for surgery on the lumbar spine:a review of the modern literature[J].Clin Neurol Neurosur,2014,119:39-43.
[7] SILVER D J,DUNSMORE R H,DICKSON C M.Spinal anesthesia for lumbar disc surgery:review of 576 operations[J].Anesth Analg,1976,55(4):550-554.
[8] JADAD A R,MOORE R A,CARROLL D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Control Clin Trials,1996,17(1):1-12.
[9] JELLISH W S,THALJI Z,STEVENSON K,et al.A prospective randomized study comparing short-and intermediate-term perioperative outcome variables after spinal or general anesthesia for lumbar disk and laminectomy surgery[J].Anesth Analg,1996,83(3):559-564.
[10] DEMIREL C B,KALAYCI M,OZKOCAK I,et al.A prospective randomized study comparing perioperative outcome variables after epidural or general anesthesia for lumbar disc surgery[J].J Neurosurg Anesth,2003,15(3):185-192.
[11] RODRIGUEZ J P,TAMBE A,DUA R,et al.Spinal or general anaesthesia for lumbar spine microdiscectomy surgery:does it matter?[J].Orthop Proc,2012,94(SUPP_III):96-96.
[12] CHOWDHURY M S,ROY S S,RAHMAN M M,et al.Comparative study in prolapse lumbar intervertebral disc(PLID) surgery by spinal vs general anaesthesia[J].J Bangladesh Soc Anaes,2010,23(2):47-50.
[13] KARA I,CELIK J B,OC B,et al.Comparison of spinal and general anesthesia in lumbar disc surgery[J].J Neurol Sci,2011,28(4):487-496.
[14] MEHRABANIAN M,REZAHOSSEINI O,MIRHOSEINI S.Spinal versus general anesthesia in lumbar laminectomy in lumbar disc herniation[J].Int J Clin Surg Adv,2013,1:6-11.
[15] HUSSAIN Z,GHAFFAR A,MUSHTAQ M J,et al.Can spinal anaesthesia be a routine for single level lumbar discectomy?[J].Pak Armed Forces Med J,2015,65(3):397-401.
[16] VURAL C,YORUKOGLU D.Comparison of patient satisfaction and cost in spinal and general anesthesia for lumbar disc surgery[J].Turk Neurosurg,2014,24(3):380-384.
[17] YILDIRIM GÜÇLÜ Ç,KEÇI·K Y,et al.Neuroendocrine and hemodynamic effects of general anesthesia and spinal anesthesia for minimally invasive lumbar disc surgery:a randomized trial[J].J Neurol Sci,2014,31(3):586-595.
[18] 孙功耀.脊髓麻醉与全麻对腰椎间盘突出手术患者术后疼痛及并发症的影响[J].现代诊断与治疗,2017,28(12):2290-2291.
[19] 李甦.脊髓麻醉与全身麻醉在腰椎间盘突出手术中的临床效果对比[J].中外医疗,2017,36(26):51-53.
[20] 范怀翊.脊髓麻醉与全身麻醉在腰椎间盘突出手术中的临床效果对比[J].中外女性健康研究,2018(11):61-62.
[21] 邱敏,付勤.脊柱后路手术多模式镇痛疗效分析[J].东南大学学报(医学版),2016,35(3):398-401.
[22] WEEKLEY J S,SMITH B J,PRADHAN M.The intersection of health informatics and evidence-based medicine:computer-based systems to assist clinicians[J].Med J Australia,2000,173(7):376-378.
[23] VERSTRAETE M.Value and limitation of meta-analysis[J].Pathophysiol Haemo T,2002,32(5-6):278-281.
[24] OREMUS M,WOLFSON C,PERRAULT A,et al.Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer's disease drug trials[J].Dement Geriatr Cogn,2001,12(3):232-236.
[25] BHOGAL S K,TEASELL R W,FOLEY N C,et al.The PEDro scale provides a more comprehensive measure of methodological quality than the Jadad scale in stroke rehabilitation literature[J].J Clin Epidemiol,2005,58(7):668-673.