右美托咪定对全身麻醉下行非心脏手术老年患者术后早期认知功能影响的Meta分析

发布时间：2018-03-26 06:46

本文选题：右美托咪定　切入点：认知功能　出处：《临床麻醉学杂志》2017年01期

【摘要】：目的通过Meta分析的方法探讨右美托咪定对全身麻醉下行非心脏手术老年患者术后认知功能的影响。方法计算机检索Cochrane Library、MEDLINE、EMbase、Ovid、Springer、CBM、CNKI、VIP和WanFang Data,同时手工检索图书馆馆藏期刊,检索年限为数据库建库至2016年10月。收集国内外研究人员发表的关于右美托咪定对全身麻醉下行非心脏手术老年患者术后认知功能影响的随机对照临床试验(RCT),由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评估方法学质量。采用RevMan 5.3软件,对符合标准的文献进行Meta分析。结果共纳入22篇RCT,1 713例患者。Meta分析结果显示:术后1、3、7d右美托咪定组的简易智能量表(MMSE)评分明显高于对照组[MD(95%CI)分别为2.99(2.25,3.74),1.66(0.68,2.64),1.52(0.55,2.49)](P0.05);右美托咪定组术后神经元特异性烯醇化酶(NSE)、S100β蛋白、促炎症细胞因子TNF-α及IL-6水平明显低于生理盐水组(P0.05)。结论围术期应用右美托咪定可抑制术中应激反应和炎性反应,改善非心脏手术老年患者术后早期认知功能。
[Abstract]:Objective to investigate the effect of dexmetomidine on the cognitive function of elderly patients undergoing non-cardiac surgery under general anesthesia by means of Meta analysis. Methods to search Cochrane Library, MEDLINE, Ovidbase, Meta, CNKI, VIP and WanFang data, and to manually search library journals. The database was built up to October 2016. A randomized controlled clinical trial published by domestic and foreign researchers on the effects of dexmetomidine on cognitive function in elderly patients undergoing non-cardiac surgery under general anesthesia was conducted. The two researchers independently sifted the literature according to the inclusion and exclusion criteria. Extraction of information and evaluation of methodological quality. Software RevMan 5.3, Results A total of 22 RCTs were included in 1 713 patients. Meta-analysis results showed that the score of MMSE in the right metoimidine group was significantly higher than that in the control group (2.99 卤2.253.741.660.682.64) and right metomidine was 1.520.55.49). Group A: neuron specific enolase NSEP S100 尾 protein, The levels of TNF- 伪 and IL-6 in the proinflammatory cytokines were significantly lower than those in the saline group (P 0.05). Conclusion the perioperative application of dexmetomidine can inhibit the stress and inflammatory response during the operation and improve the early cognitive function of the elderly patients undergoing non-cardiac surgery.
【作者单位】：皖南医学院附属弋矶山医院麻醉科;
【分类号】：R614.2

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