围术期电针干预对术后谵妄影响的Meta分析

Effect of perioperative electroacupuncture intervention on postoperative delirium:a meta-analysis

目的系统评价围术期电针干预对全麻手术患者术后谵妄(POD)的影响。方法计算机检索PubMed、Embase、Cochrane、中国知网、万方和中国生物医学文献数据库(CBM),收集电针干预对全麻手术患者POD的随机对照试验(RCT),检索时间为建库至2022年3月。采用RevMan 5.3软件进行Meta分析。结果共纳入11篇RCT研究,共计患者924例,电针组463例,对照组461例。与对照组比较,电针组POD发生率明显降低(RR=0.44,95%CI 0.35~0.54,P<0.001),术后1 d血清S100β蛋白(SMD=-1.83,95%CI-2.66~-1.01,P<0.001)和神经元特异性烯醇化酶(NSE)浓度(MD=-3.85 ng/ml,95%CI-4.39~-3.31 ng/ml,P<0.001)明显降低。结论围术期使用电针可降低患者POD的发生率、降低患者术后1 d血清S100β蛋白和NSE浓度。

Objective To systematically evaluate the effectiveness of perioperative electroacupuncture intervention on postoperative delirium(POD)in patients undergoing general anesthesia.Methods The articles of randomized controlled trials(RCTs)of electroacupuncture treatment for postoperative delirium were retrieved from the following databases from the time of database establishment to March 2022,PubMed,Embase,Cochrane Central Register of Controlled Trials(CENTRAL),China National Knowledge Infrastructure(CNKI),Wanfang database,and China Biomedical Literature Database(CBM).RevMan 5.3 software was used for meta-analysis.Results A total of 11 RCTs with 924 patients were included,463 patients in electroacupuncture group,461 patients in the control group.Compared with the control group,the incidence of POD in the electroacupuncture group was significantly lower(RR=0.44,95%CI 0.35 to 0.54,P<0.001),and the concentrations of the serum S100βprotein(SMD=-1.83,95%CI-2.66 to-1.01,P<0.001)and neuron-specific enolase(NSE)(MD=-3.85 ng/ml,95%CI-4.39 to-3.31 ng/ml,P<0.001)were significantly reduced on the 1st day after surgery.Conclusion Perioperative electroacupuncture intervention can reduce the incidence of POD,serum S100βprotein and NSE concentrations on the first day after surgery.