颅脑损伤患者轻度认知功能障碍影响因素的Meta分析

Meta-analysis of influencing factors of mild cognitive impairment in patients with traumatic brain injury

目的通过Meta分析明确颅脑损伤患者轻度认知障碍的影响因素。方法检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane Library等数据库,从建库至2022年8月的所有有关颅脑损伤患者轻度认知功能障碍的文献及纳入文献的参考文献,由2名评价人员按照标准独立筛选文献、提取资料、评价文献质量。采用RevMan 5.3软件对资料进行Meta分析。结果共纳入17篇文献,16个危险因素,样本量为11750例。Meta分析结果显示,年龄(OR=3.03)、受教育程度(OR=2.46)、额叶受损(OR=4.84)、颞叶受损(OR=6.01)、左半球受损(OR=5.02)、多部位损伤(OR=6.80)是颅脑损伤患者轻度认知障碍的影响因素。结论临床护理人员应加强对颅脑损伤患者认知障碍的评估和筛查,重视认知储备(年龄及受教育程度)的潜在影响及不同部位受损的认知域特征,及早进行有针对性的干预,以改善患者临床结局。

Objective To identify the risk factors of mild cognitive impairment in patients with traumatic brain injury by meta-analysis.Methods China National Knowledge Network,Wanfang Database,China Biomedical Literature Database,PubMed,Embase,Cochrane Library and other databases were searched for studies on mildl cognitive impairment in patients with craniocerebral injury from the establishment of the database to August 2022 and the references of included studies were ineluded.Two reviewers sereened the literature according to thel inclusion and exclusion criteria,and extracted data,assessed the quality of included studies independently.Meta-analysis was conducted by Rev Man 5.3.Results A total of 17 studics and 16 risk factors were included,with al sample size of 11750 cases.The meta-analysis result showed that the risk factors were age(OR-3.03),edueationl level(OR=2.46),damage of frntal lobe(OR=4.84),damage of temporal lobe(OR=6.01),damage of left hemispherel(OR-5.02),multi-site injury(OR=6.80).Conclusion Clinical nursing staff should strengthen the assessment andl screening of cognitive impairment in patients with brain injury,pay attention to the potential impact of cognitive reserve(age and education level)and the characteristics of different damaged areas of cognitive domain,target early and effective intervention to improve the elinical outcome of patients.