心脏术后患者认知功能障碍危险因素的Meta分析

发布时间：2018-05-27 06:42

本文选题：心脏外科手术 + 认知障碍　；参考：《中华护理杂志》2016年07期

【摘要】：目的通过Meta分析明确心脏术后认知功能障碍(postoperative cognitive dysfunction,POCD)的危险因素。方法通过进行文献质量评价,应用Rev Man 5.3分析软件进行敏感性和异质性分析,并采用固定效应或随机效应模型计算合并后的综合效应。结果 19篇文献符合纳入标准,POCD组1104例,非POCD组2800例,共纳入心脏POCD危险因素28个。经Meta分析,年龄、女性、受教育年数、BMI、糖尿病、脑卒中史、术前抑郁、心力衰竭、左室射血分数30%、头颅CT脑血管重度狭窄、机械通气时间、ICU时间、血肌酐水平异常具有综合效应,为心脏POCD的独立预测因素。结论高龄、缺氧、机械通气时间延长,以及留置ICU时间延长是心脏POCD的独立预测因素,而女性、心力衰竭、麻醉用药及术前抑郁对心脏术后认知功能的预测价值,证据尚不充分。
[Abstract]:Objective to determine the risk factors of postoperative cognitive dysfunction POCD by Meta analysis. Methods based on the literature quality evaluation, the sensitivity and heterogeneity were analyzed by Rev Man 5.3 software, and the combined effects were calculated by the fixed or random effect model. Results there were 1104 cases in POCD group and 2800 cases in non-POCD group, and 28 risk factors of cardiac POCD were included in 19 articles. By Meta analysis, age, female, years of education, BMI, diabetes, stroke history, preoperative depression, heart failure, left ventricular ejection fraction (LVEF), cranial CT severe cerebral vascular stenosis, mechanical ventilation time and ICU time. The abnormal serum creatinine level has a comprehensive effect and is an independent predictor of cardiac POCD. Conclusion Old age, hypoxia, prolonged mechanical ventilation and prolonged retention of ICU are independent predictors of cardiac POCD, while women, heart failure, anaesthesia and depression before and after cardiac surgery are the predictors of cognitive function. The evidence is insufficient.
【作者单位】：首都医科大学护理学院;首都医科大学附属北京朝阳医院;
【基金】：国家自然科学基金面上课题(81170170)
【分类号】：R473.6

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