非心脏手术中脑氧饱和度监测对术后谵妄影响的Meta分析

The effect of cerebral oxygen saturation monitoring during non-cardiac surgery on postoperative delirium: a Meta-analysis

目的通过Meta分析的方法系统评价非心脏手术中使用脑氧饱和度(rSO2)监测对术后谵妄的影响。方法计算机从建库至2019年8月系统检索PubMed、web of science、Embase、Cochrane、知网、维普、万方数据库,全面收集符合纳入标准的随机对照试验。分别由两位课题组人员,按照纳入与排除标准独立进行文献筛查并对入选文章进行文献质量评价。使用Revman 5.3 Meta分析。结果本研究共纳入5项随机对照试验,包括符合标准的患者446名,其中观察组206名,对照组240名。Meta分析结果显示,术中使用脑氧饱和度监测并干预处理的观察组比不进行脑氧饱和度监测的对照组术后谵妄的发生率明显减低,差异具有统计学意义(OR=0.62,95%CI:0.39~0.99,P<0.05)。结论术中使用脑氧饱和度监测并干预能够有效减少非心脏手术患者术后谵妄的发生。

Objective To systematically evaluate the effect of cerebral oxygen saturation monitoring during non-cardiac surgery on postoperative delirium by Meta-analysis.Methods Systematic retrieval of PubMed,web of science,Embase,Cochrane,China National Knowledge Infrastructure(CNKI),VIP net and Wanfang databases was conducted by computer from the date of database establishment to August 2019,and all randomized controlled trials meeting the inclusion criteria were collected.Two members of research team conducted literature screening independently according to inclusion and exclusion criteria and evaluated the literature quality of selected articles.Meta-analysis was performed using Revman 5.3.Results Five randomized controlled trials were included,including 446 eligible patients,206 patients in the observation group and 240 patients in the control group.Meta-analysis results showed that the incidence of postoperative delirium in the observation group with intraoperative cerebral oxygen saturation monitoring and intervention treatment was significantly lower than that in the control group without cerebral oxygen saturation monitoring,and the difference was statistically significant(OR=0.62,95%CI:0.39~0.99,P<0.05).Conclusion Intraoperative cerebral oxygen saturation monitoring and intervention can effectively reduce the occurrence of postoperative delirium in patients undergoing non-cardiac surgery.