老年患者髋关节置换术后谵妄危险因素的Meta分析  

Risk factors for delirium following hip arthroplasty in the elderly:a Meta-analysis

作　　者：方敏[1,2] 高兴莲 柯稳 王曾妍 梁元元 Fang Min;Gao Xinglian;Ke Wen;Wang Zengyan;Liang Yuanyuan(School of Nursing,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院护理学院,湖北武汉430030 [2]华中科技大学同济医学院附属协和医院

出　　处：《护理学杂志》2023年第15期101-106,共6页Journal of Nursing Science

摘　　要：目的系统分析老年髋关节置换术患者发生术后谵妄的危险因素,为临床护理实践提供参考。方法在PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据、维普数据库、中国生物医学文献数据库中搜集相关文献,检索时限为建库至2022年11月1日,由2名研究者对文献进行筛选、资料提取和质量评价后,采用RevMan 5.4软件进行Meta分析。结果共纳入23篇文献,包括19298例患者。Meta分析结果显示,年龄、男性、股骨颈骨折、术后低氧血症、糖尿病、卒中史、痴呆/术前认知功能障碍、全身麻醉、ASA分级高、术后VAS疼痛评分>3分、低水平血红蛋白、受伤至手术时间>3 d是老年髋关节置换术后谵妄的危险因素(均P<0.05)。结论老年髋关节置换术后发生谵妄受较多因素影响,医护人员应针对谵妄危险因素,进行早期筛查、及早干预。但受纳入研究所限,上述结论尚需要更多高质量研究予以验证。Objective To systematically analyze the risk factors of delirium in elderly patients after hip arthroplasty,and to provide a reference for clinical nursing practice.Methods Such databases as PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wanfang Data,VIP and SinoMed were searched to retrieve relevant publications published from database inception to November 1,2022.Two researchers independently performed literature screening,data extraction,and methodological quality appraisal.RevMan 5.4 was used for Meta-analysis.Results A total of 23 publications were included,involving 19298 patients.Meta-analysis revealed that age,male,femoral neck fracture,postoperative hypoxemia,diabetes,stroke history,dementia/preoperative cognitive impairment,general anesthesia,ASA score,length of operation,postoperative VAS pain score,hemoglobin,time from injury to operation>3 d were the risk factors of delirium following hip arthroplasty in the elderly(all P<0.05).Conclusion Deli-rium after hip arthroplasty in the elderly is subjected to multiple factors.Medical staff should screen and take intervention early on according to the risk factors of delirium.However,due to the limitations of the included studies,the above conclusions need to be verified by more high quality studies.

关 键 词：老年人 髋关节置换术 髋关节功能 术后谵妄 股骨颈骨折 低氧血症 危险因素 META分析 

分 类 号：R473.6[医药卫生—护理学]