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目的 系统评价喉罩与气管插管对腹腔镜手术患者的有效性和安全性.方法 计算机检索PubMed、EMbase、The Cochrane Library、CNKI、WanFang Data和CBM数据库,搜集有关喉罩与气管插管比较对腹腔镜手术患者有效性和安全性的随机对照试验(RCT),检索时限均从建库至2017年4月.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入16个RCT,1 593例患者.Meta分析结果显示:喉罩组与气管插管组首次插入成功率差异无统计学意义[RR=0.99,95％CI (0.96,1.02),P=0.55].头高脚低位患者喉罩组气道压力低于气管插管组[MD=-1.20,95％CI(-1.81,-0.59),P=0.000 1];而头低脚高位患者两组气道压力差异无统计学意义[MD=0.48,95％CI(-0.90,1.87),P=0.49].喉罩组咽喉疼痛发生率[RR=0.58,95％CI (0.46,0.74),P＜0.000 01]、导管血染发生率[RR=0.48,95％CI (0.30,0.77),P=0.002]、喉痉挛/支气管痉挛发生率[OR=0.30,95％CI (0.11,0.80),P=0.02]和拔管呛咳/呃逆发生率[RR=0.10,95％CI (0.07,0.15),P＜0.000 01]均低于气管插管组.结论 当前证据表明,与气管插管相比,喉罩能够有效降低腹腔镜手术头高脚低位患者气道压力.喉罩比气管插管的并发症的发生风险低,在维持患者正常呼吸功能的同时减少损伤且不增加反流误吸发生.受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证.“,”Objective To systematically review the efficacy and safety oflaryngeal mask versus endotracheal tubes for laparoscopic surgery.Methods PubMed,EMbase,The Cochrane Library,CNKI,WanFang Data and CBM databases were electronically searched to collect the randomized controlled trials (RCTs) about the efficacy and safety of laryngeal mask versus endotracheal tubes for laparoscopic surgery from inception to April,2017.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.Results A total of 16 RCTs involving 1 593 patients were included.The results ofmeta-analysis showed that:there was no significant difference in the success rate of the first insertion (RR=0.99,95％CI 0.96 to 1.02,P=0.55).The airway pressure of patients whose position were head higher than foot was significantly lower in the laryngeal mask group than in the tracheal intubation group (MD=-1.20,95％CI-1.81 to-0.59,P=0.000 1),but there was no significant difference between two groups in reverse position patients (MD=0.48,95％CI-0.90 to 1.87,P=0.49).The incidence of sore throat (RR=0.58,95％CI 0.46 to 0.74,P＜0.000 01),the incidence of blood stain (RR=0.48,95％CI 0.30 to 0.77,P=0.002),the incidence of laryngeal spasm/bronchial spasm (OR=0.30,95％CI 0.11 to 0.80,P=0.02) and the incidence of cough/hiccup (RR=0.10,95％CI 0.07 to 0.15,P＜0.000 01) in the laryngeal mask group were significantly lower than those in the tracheal intubation group.Conclusion The current evidence shows that compared with tracheal intubation,laryngeal mask can effectively reduce airway pressure of patients whose position are head higher than foot.The risks of various complications are significant higher in tracheal intubation in laparoscopic surgery.Laryngeal mask can maintain patients' normal respiratory functions while reduce damage and do not increase the occurrence of reflux aspiration.Due to limited quantity and quality of the included studies,more high quality studies are needed to verify above conclusion.