中国医科大学学报
中國醫科大學學報
중국의과대학학보
Journal of China Medical University
2015年
9期
790-795
,共6页
右美托咪啶%麻醉%认知功能%Meta分析%随机对照试验
右美託咪啶%痳醉%認知功能%Meta分析%隨機對照試驗
우미탁미정%마취%인지공능%Meta분석%수궤대조시험
dexmedetomidine%anesthesia%cognitive function%Meta analysis%randomized controlled trials
目的 系统评价右美托咪啶对老年患者术后认知功能障碍的影响.方法 计算机检索CNKI、万方、维普、PubMed、SCIE、Springer和EMBASE数据库,查找右美托咪啶对全麻非脑手术老年患者术后早期认知功能障碍影响的随机对照试验,按照纳入排除标准筛选文献、提取资料和评价后进行Meta分析.结果 纳入43篇文献,包括46项研究,2 876例患者.右美托咪啶能提高患者术后第1天(MD=2.37,95%CI=1.50~3.24)、第3天(MD=1.96,95%CI=1.00~2.92)和第7天(MD=1.03,95%CI=0.53~1.53)的简易智力状况检查(MMSE)评分;未使用者第1天(RR=1.92,95%CI=1.45~2.55)、第3天(RR=2.17,95%CI=1.52~3.09)和第7天(RR=1.89,95%CI=1.28~2.79)认知功能障碍发生风险显著升高.结论 右美托咪啶能有效降低患者术后认知功能障碍发生危险度,提高患者术后MMSE评分.
目的 繫統評價右美託咪啶對老年患者術後認知功能障礙的影響.方法 計算機檢索CNKI、萬方、維普、PubMed、SCIE、Springer和EMBASE數據庫,查找右美託咪啶對全痳非腦手術老年患者術後早期認知功能障礙影響的隨機對照試驗,按照納入排除標準篩選文獻、提取資料和評價後進行Meta分析.結果 納入43篇文獻,包括46項研究,2 876例患者.右美託咪啶能提高患者術後第1天(MD=2.37,95%CI=1.50~3.24)、第3天(MD=1.96,95%CI=1.00~2.92)和第7天(MD=1.03,95%CI=0.53~1.53)的簡易智力狀況檢查(MMSE)評分;未使用者第1天(RR=1.92,95%CI=1.45~2.55)、第3天(RR=2.17,95%CI=1.52~3.09)和第7天(RR=1.89,95%CI=1.28~2.79)認知功能障礙髮生風險顯著升高.結論 右美託咪啶能有效降低患者術後認知功能障礙髮生危險度,提高患者術後MMSE評分.
목적 계통평개우미탁미정대노년환자술후인지공능장애적영향.방법 계산궤검색CNKI、만방、유보、PubMed、SCIE、Springer화EMBASE수거고,사조우미탁미정대전마비뇌수술노년환자술후조기인지공능장애영향적수궤대조시험,안조납입배제표준사선문헌、제취자료화평개후진행Meta분석.결과 납입43편문헌,포괄46항연구,2 876례환자.우미탁미정능제고환자술후제1천(MD=2.37,95%CI=1.50~3.24)、제3천(MD=1.96,95%CI=1.00~2.92)화제7천(MD=1.03,95%CI=0.53~1.53)적간역지력상황검사(MMSE)평분;미사용자제1천(RR=1.92,95%CI=1.45~2.55)、제3천(RR=2.17,95%CI=1.52~3.09)화제7천(RR=1.89,95%CI=1.28~2.79)인지공능장애발생풍험현저승고.결론 우미탁미정능유효강저환자술후인지공능장애발생위험도,제고환자술후MMSE평분.
Objective To systematically evaluate the effects of dexmedetomidine on postoperative cognitive dysfunction(POCD)in elderly pa?tients. Methods Randomized controlled trials about effects of dexmedetomidine on postoperative cognitive dysfunction in elderly patients under?went brain surgery were searched in the following databases:CNKI,Wanfang,VIP,PubMed,SCIE,Springer and EMBASE. According to the inclu?sion and exclusion criteria,we screened the literature,extracted data and performed a Meta analysis. Results A total of 43 publication involving 46 studies and 2 876 patients were collected for this Meta analysis. The results showed that the dexmedetomidine can improve the postoperative mini?mental state examination(MMSE)score on the first day(MD=2.37,95%CI=1.50?3.24),the third day(MD=1.96,95%CI=1.00?2.92,)and the seventh day(MD=1.03,95%CI=0.53?1.53). Nonusers had significantly higher risk of POCD on the first day(RR=1.92,95%CI=1.45?2.55),the third day(RR=2.17,95%CI=1.52?3.09)and the seventh day(RR=1.89,95%CI=1.28?2.79). Conclusion Dexmedetomidine can effectively re?duce the incidence of POCD and improve postoperative MMSE scores in elderly patients.
