经皮穴位电刺激预防老年患者术后谵妄的Meta分析

Effect of Transcutaneous Electrical Acupoint Stimulation on Postoperative Delirium in Elderly Patients:A Meta-Analysis

目的:采用Meta分析评价经皮穴位电刺激(TEAS)在预防老年患者术后谵妄(POD)中的效果。方法:系统检索Pubmed、Cochrane Library、Web of Science、Embase、中国知网、万方和维普等数据库,收集建库至2023年8月30日关于TEAS治疗老年手术患者的随机对照试验(RCTs),采用RevMan 5.3软件进行Meta分析。结果:本研究共纳入22篇文献,共2645例研究对象。Meta分析结果显示,TEAS能降低老年患者术后POD的发生率(RR=0.46,95%CI:0.38,0.56),接受骨科手术(RR=0.50,95%CI:0.40,0.63)、腹部手术(RR=0.41,95%CI:0.25,0.65)及肿瘤手术(RR=0.33,95%CI:0.19,0.57)的老年患者术后POD的发生率均显著下降(均P<0.001);TEAS术中全程(RR=0.39,95%CI:0.29,0.53)或延续到术后(RR=0.52,95%CI:0.36,0.75)可明显降低老年患者术后POD发生率。结论:TEAS可有效降低行骨科、腹部及肿瘤等手术的老年患者术后POD的发生,TEAS术中全程使用或延续到术后均能有效抑制老年患者术后POD的发生,值得临床推广应用。

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)in preventing postoperative delirium(POD)among elderly patients using meta-analysis.Methods:Databases such as PubMed,Cochrane Library,Web of Science,Embase,CNKI,Wanfang,and VIP were systematically searched to collect randomized controlled trials(RCTs)on TEAS for the treatment of elderly surgical patients from the establishment of the databases to August 30,2023.Meta-analysis was performed using RevMan 5.3 software.Results:A total of 22 studies with 2645 participants were included in this study.The meta-analysis showed that TEAS could reduce the incidence of POD in elderly patients(RR=0.46,95%CI:0.38,0.56).The incidence of POD in elderly patients undergwent orthopedic surgery(RR=0.50,95%CI:0.40,0.63),abdominal surgery(RR=0.41,95%CI:0.25,0.65),and tumor surgery(RR=0.33,95%CI:0.19,0.57)were significantly reduced(all P<0.001).TEAS applied throughout the intraoperative period(RR=0.39,95%CI:0.29,0.53)or continued postoperatively(RR=0.52,95%CI:0.36,0.75)could significantly reduce the incidence of POD in elderly patients.Conclusion:TEAS can reduce the incidence of POD in elderly patients undergoing orthopedic,abdominal,and tumor surgeries.The use of TEAS throughout the intraoperative period or continuation postoperatively can effectively suppress the occurrence of POD in elderly patients,which is worthy of clinical promotion and application.