头颈部肿瘤患者术后发生谵妄危险因素的meta分析

doi:10.19438/j.cjoms.2023.04.015

摘要/Abstract

摘要： 目的：明确头颈部肿瘤患者术后发生谵妄的危险因素,为临床患者的早期预防提供依据。方法：计算机检索PubMed、Embase、The Cochrane Library、Web of Science、中国知网（CNKI）、万方数据库、中国生物文献数据库（CBM）、维普数据库,收集头颈部肿瘤患者术后谵妄危险因素的队列研究、病例对照研究,检索时限为建库至2022年5月。采用RevMan 5.0软件进行meta分析。结果：纳入15项研究,样本量为5801例。头颈部肿瘤患者术后谵妄的危险因素有13项,即年龄(WMD=7.24)、性别(OR=1.99)、合并高血压(OR=2.94)、合并糖尿病(OR=1.49)、合并精神疾病(OR=3.50)、吸烟史(OR=1.79)、ASA分级≥Ⅲ级(OR=2.43)、麻醉时间(WMD=32.87)、气管切开(OR=2.25)、颈淋巴清扫术(OR=2.47)、术中失血量(WMD=124.77)、术后睡眠紊乱(OR=5.28)及术后电解质紊乱(OR=2.45)等。结论：临床医护人员应重点评估和管理危险人群,尽可能减少头颈部肿瘤患者术后谵妄的发生,改善患者临床预后。

关键词: 头颈部肿瘤, 谵妄, 危险因素, Meta分析

Abstract: PURPOSE: To identify the risk factors of postoperative delirium in patients with head and neck tumours and provide evidence for early prevention of clinical patients. METHODS: A systematic search of PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, CBM and VIP was conducted. Cohort studies and case-control studies on risk factors for postoperative delirium in patients with head and neck tumours were collected. The retrieval period was from the database construction to May 2022. RevMan 5.0 software was used for meta analysis. RESULTS: A total of 15 articles were included, with a sample size of 5801 cases, including 13 risk factors: age(WMD=7.24), gender(OR=1.99), with hypertention(OR=2.94), with diabetes(OR=1.49), preoperative mental disease(OR=3.50), smoking history (OR=1.79), ASA grade≥Ⅲ(OR=2.43), time of anesthesia (WMD=32.87), tracheotomy(OR=2.25), neck dissection (OR=2.47), intraoperative blood loss(WMD=124.77), postoperative sleep disorder(OR=5.28) and postoperative electrolyte disorder (OR=2.45). CONCLUSIONS: Medical staff should focus on the assessment and management of risk populations, reduce postoperative delirium in patients with head and neck tumours as much as possible, and improve the clinical prognosis of patients.

Key words: Head and neck tumours, Delirium, Risk factors, Meta analysis

中图分类号:

R739.8

向富萍, 侯黎莉, 杨玲, 王钰, 梁家青. 头颈部肿瘤患者术后发生谵妄危险因素的meta分析[J]. 中国口腔颌面外科杂志, 2023, 21(4): 407-412.

XIANG Fu-ping, HOU Li-li, YANG Ling, WANG Yu, LIANG Jia-qing. Meta analysis of risk factors for postoperative delirium in patients with head and neck tumours[J]. China J Oral Maxillofac Surg, 2023, 21(4): 407-412.

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