老年手术病人术前营养不良对术后谵妄发生率影响的Meta分析  

Impact of preoperative malnutrition on postoperative delirium incidence in elderly surgical patients:a Meta analysis

作　　者：李凤 李乃艳[1] 邵明珠 LI Feng;LI Naiyan;SHAO Mingzhu(Linyi People′s Hospital,Shandong 276000 China)

机构地区：[1]临沂市人民医院,山东276000

出　　处：《循证护理》2024年第23期4203-4209,共7页Chinese Evidence-Based Nursing

摘　　要：目的:了解术前营养不良的老年手术病人术后谵妄现状,探讨术前营养不良与术后谵妄发生的影响因素。方法:计算机检索PubMed、CINAHL、EMbase、the Cochrane Library、Web of Science、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中有关术前营养不良的老年手术病人术后谵妄发生的相关文献,检索时限为2013年4月1日—2023年4月30日。采用RevMan 5.3软件对符合纳入标准的文献资料进行Meta分析。结果:共纳入15篇文献,涉及病人4 374例,术前营养不良的老年手术病人术后谵妄发生率为15.90%~87.19%。Meta分析结果显示,存在营养不良风险、营养不良的老年手术病人术后谵妄发生率分别为30%[95%CI(0.24,0.35),P<0.000 01]、48%[95%CI(0.37,0.59),P<0.000 01];术前营养不良风险、营养不良均为术后谵妄的影响因素,术前营养不良风险、营养不良的老年手术病人术后谵妄发生风险分别是营养正常者的2.37倍、1.88倍。结论:现有证据表明,术前营养不良的老年手术病人术后谵妄发生率较高,术前营养不良风险、营养不良均是导致老年手术病人术后谵妄发生的危险因素,存在术前营养不良风险、营养不良的老年手术病人有更高的术后谵妄风险,有必要开展护理干预改善老年手术病人术前营养不良状况预防术后谵妄的发生。Objective:To understand the current status of postoperative delirium in elderly surgical patients with preoperative malnutrition,and to explore the influencing factors of preoperative malnutrition and postoperative delirium.Methods:Literature about postoperative delirium in elderly surgical patients with preoperative malnutrition were searched in PubMed,CINAHL,EMbase,the Cochrane Library,Web of Science,CNKI,WanFang Database,VIP,CBM.The retrieval time was from April 1,2013 to April 30,2023.Meta-analysis was performed on the literature that met the inclusion criteria using RevMan 5.3 software.Results:A total of 15 articles and 4374 patients were included.The incidence of postoperative delirium in elderly surgical patients with preoperative malnutrition ranged from 15.90%to 87.19%.The results of Meta-analysis showed that the incidence of postoperative delirium in elderly surgical patients with malnutrition risk and malnutrition was 30%(95%CI 0.24-0.35,P<0.00001)and 48%(95%CI 0.37-0.59,P<0.00001).Preoperative malnutrition risk and malnutrition were both factors affecting postoperative delirium.Elderly surgical patients with preoperative malnutrition risk and malnutrition had about 2.37 times,1.88 times the risk of suffering postoperative delirium higher than those with normal nutrition.Conclusion:Current evidence shows that the incidence of postoperative delirium is higher in elderly surgical patients with preoperative malnutrition.Preoperative malnutrition risk and malnutrition are both factors affecting postoperative delirium.The elderly surgical patients with preoperative malnutrition risk and malnutrition have a higher risk of postoperative delirium,nursing interventions are necessary to improve the preoperative malnutrition status of preoperative malnutrition to prevent postoperative delirium.

关 键 词：老年人 术前营养不良 术后谵妄 META分析 循证护理 

分 类 号：R473.6[医药卫生—护理学]