麻醉方式与术后谵妄、术后认知功能障碍关系的Meta分析  

Meta analysis of the relationship between postoperative delirium and cognitive dysfunction and the anesthesia procedure

作　　者：陈怡霏[1] 段晓霞[2] 彭钢[3] 胡德春[3] 刘宏锦[2] 张官鹏[2] 

机构地区：[1]绵阳市中心医院麻醉科,四川绵阳621000 [2]泸州医学院附属医院麻醉科,四川泸州646000 [3]泸州医学院,四川泸州646000

出　　处：《海南医学院学报》2016年第4期404-407,共4页Journal of Hainan Medical University

基　　金：泸州医学院课题(2013ZRQN082);泸州医学院附属医院课题(14020)~~

摘　　要：目的:采用系统的文献回顾与Meta分析方法评价全身麻醉与局部麻醉对患者术后谵妄和术后认知功能障碍发生情况的影响。方法:以相应关键词系统搜索万方和维普中文数据库,同时检索MEDLINE,EMBASE,PsycINFO以及ISI Web of Knowledge英文数据库。对纳入的文献逐个进行评价,使用STATA 12.0进行meta分析。结果:共纳入16项研究。结果显示:全麻与局麻对于术后谵妄、术后认知功能障碍的效应合并值分别为:OR=0.85(95%CI=0.66,1.04),OR=1.38(95%CI=0.88,1.88)。全身麻醉可能会减少术后谵妄的发生,但增加术后认知功能障碍发生的风险。亚组分析表明骨科,泌尿科,心血管科和普外科效应合并OR和95%置信区间无明显差异。结论:此meta分析证明术后谵妄、术后认知功能障碍的发生和麻醉方式无关。Objective： To investigate the effects of general anesthesia and regional anesthesia on the occurrence of post operative delirium and postoperative cognitive dysfunction by method of systematic literature review and Meta analysis. Meth- ods： Corresponding key words were systematically searched in Chinese database of Wangfang and Weipu, as well as English database including MEDLINE, EMBASE, PsycINFO and ISI Web of Knowledge. Included literatures were evaluated one by one, and STATA 12.0 was used for Meta analysis. Results： A total of 16 studies were included. Results showed that corn bined effect values of general anesthesia and regional anesthesia on postoperative delirium and postoperative cognitive dysfunc- tion were OR=0. 85 （95%CI=0.66, 1.04） and OR=1. 38 （95%CI=0.88, 1.88） respectively. General anesthesia might re duce the occurrence of postoperative delirium but increase the risk of postoperative cognitive dysfunction. Subgroup analysis showed that there were no significant differences in combined effect OR and 950~ confidence interval of orthopedics, urology, cardiology and general surgery. Conclusion： The Meta analysis proves that the occurrence of postoperative delirium arid postop erative cognitive dysfunction are not related to anesthesia.

关 键 词：术后谵妄 术后认知功能障碍 局部麻醉 全身麻醉 META分析 

分 类 号：R614[医药卫生—麻醉学]