摘要
目的:通过Meta分析明确神经外科患者术后谵妄的发生率及相关危险因素,为临床早期识别和术后谵妄预防提供依据.方法:计算机检索中、英文数据库中关于神经外科术后谵妄发生率及影响因素的文献,检索时限为建库至 2023 年 6月.对文献进行质量评价,数据提取后采用Stata 15.0 软件进行统计分析.结果:共纳入24篇文献,提取出20 项影响因素进行Meta合并.Meta分析结果显示,神经外科患者术后谵妄发生率为24%.年龄、性别、焦虑或抑郁、肿瘤直径、肿瘤性质、高血压史、术前脑缺血、术后GCS评分、术后双额积气、低蛋白血症、低血氧饱和度、发热、睡眠障碍、额下入路术式、使用苯二氮卓类药物及身体约束是神经外科术后谵妄发生的危险因素.结论:神经外科患者术后谵妄发生率较高,临床医护人员应加强对谵妄的监测和管理,根据相关危险因素早期识别高危人群并进行有针对性的预防和控制.
Abstract
Objective:To identify the incidence and risk factors of postoperative delirium in neurosurgery patients through Meta-analysis,and to provide evidence for early clinical identification and prevention of postoperative delirium.Methods:Literature on the incidence and risk factors of postoperative delirium in neurosurgery were retrieved from PubMed,Web of Science,Cochrane Library,CINAHL,CNKI,VIP,and WanFang Data from inception to June 2023.After literature quality evaluation and data extraction,Stata 15.0 software was used for statistical analysis.Results:A total of 24 studies were included,and 20 risk factors were extracted for Meta-analysis.The results showed that the incidence of postoperative delirium was 24%.Age,gender,anxiety or depression,tumor diameter,tumor nature,history of hypertension,preoperative cerebral ischemia,postoperative GCS score,postoperative bilateral frontal pneumocephalus,hypoproteinemia,hypoxemia,fever,sleep disturbance,frontal approach craniotomy,benzodiazepine use,and physical restraint are risk factors for postoperative delirium in neurosurgery.Conclusion:The incidence of postoperative delirium is high in neurosurgery patients.Clinical staff should strengthen the monitoring and management of delirium,identify high-risk groups according to relevant risk factors,and carry out targeted measures to prevent and control the development of delirium.
基金项目
福建医科大学附属第一医院院级护理专项创新研究项目(2022FY-HZ-16)
福建省神经疾病医学中心-神经外科"创双高"建设项目(2023YSJYX-HLJS-4)
NETL
NSTL
万方数据