脑肿瘤患者术后谵妄危险因素的荟萃分析

A Meta-analysis of risk factors for delirium after brain tumor surgery

目的采用荟萃分析探讨脑肿瘤患者术后谵妄发生的危险因素,旨在为临床护理人员识别高危因素提供依据。方法以谵妄、脑肿瘤、手术、危险因素等为关键词,检索PubMed、Web of Science、中国知网、万方等国内外数据库于2001年1月1日—2020年12月16日发表的脑肿瘤术后谵妄相关文献,进行文献质量评价并采用Stata 16.0软件进行Meta分析。结果共纳入9篇文献,13个危险因素与脑肿瘤患者术后发生谵妄相关。汇总分析后,年龄≥50岁或≤5岁[OR=1.23,95%CI(1.09~1.38),P=0.001]、酗酒史[OR=2.12,95%CI(1.09~4.13),P=0.027]、左右双侧脑肿瘤占位[OR=2.19,95%CI(1.30~3.69),P=0.003]、使用苯二氮类药物[OR=4.11,95%CI(2.03~8.30),P<0.001]、经额入路开颅术[OR=3.12,95%CI(1.94~5.00),P<0.001]、气管插管[OR=4.45,95%CI(2.44~8.11),P<0.001]、身体约束[OR=2.86,95%CI(1.82~4.51),P<0.001]是脑肿瘤患者术后谵妄发生的危险因素。结论现有证据表明,年龄≥50岁或≤5岁、酗酒史、左右双侧脑肿瘤占位、使用苯二氮类药物、经额入路开颅术、气管插管、身体约束是脑肿瘤患者术后谵妄发生的危险因素。护理人员应识别高危患者,基于危险因素采取预防策略以减少该群体术后谵妄的发生。

Objective To explore the risk factors for delirium after brain tumor surgery using a Meta-analysis,so as to provide a basis for clinical nurses to identify high-risk factors.Methods Using the key words of delirium,brain tumor,surgery,risk factors and so on,the articles on delirium after brain tumor surgery were retrieved from authoritative databases at home and abroad such as PubMed,Web of Science,China National Knowledge Infrastructure(CNKI)and WanFang Data from January 1,2001 to December 16,2020.The quality of the article was evaluated and Meta-analysis was performed using Stata 16.0.Results A total of 9 articles were included,and 13 risk factors were associated with delirium after brain tumor surgery.After Meta-analysis,age≥50 years or≤5 years[OR=1.23,95%CI(1.09-1.38),P=0.001],history of alcoholism[OR=2.12,95%CI(1.09-4.13),P=0.027],left and right bilateral brain tumors[OR=2.19,95%CI(1.30-3.69),P=0.003],using benzodiazepines[OR=4.11,95%CI(2.03-8.30),P<0.001],transfrontal craniotomy[OR=3.12,95%CI(1.94-5.00),P<0.001],tracheal intubation[OR=4.45,95%CI(2.44-8.11),P<0.001],physical restraint[OR=2.86,95%CI(1.82-4.51),P<0.001]were risk factors for delirium after brain tumor surgery.Conclusions Available evidence suggests that age≥50 years or≤5 years,history of alcoholism,left and right bilateral brain tumors,using benzodiazepines,transfrontal craniotomy,tracheal intubation,and physical restraint are risk factors for postoperative delirium in patients with brain tumors.High-risk patients should be identified,and preventive strategies should be adopted based on risk factors to reduce the incidence of postoperative delirium in this population.