摘要
目的系统评价椎管内麻醉(SA)与全身麻醉(GA)对髋部骨折患者术后谵妄的影响。方法系统检索PubMed、Cochranelibrary、Web of science和Embase4个数据库,搜集建库至2022年2月有关SA和GA应用于髋部骨折手术对术后谵妄影响的随机对照研究文献。由2名研究人员独立完成文献筛选、数据提取和文献质量评价,并采用RevMan5.4软件进行Meta分析。结果共纳入9篇随机对照研究文献,患者3235例,其中SA组1610例,GA组1625例。Meta分析显示:SA组和GA组术后4 d和7 d的谵妄发生率比较,差异无统计学意义(RR=1.03、1.05,95%CI:0.67~1.60、0.89~1.25,P>0.05);两组总住院时间、术后3个月死亡率比较,差异均无统计学意义(P>0.05)。结论与GA相比,SA不能降低髋部骨折术后4 d和7 d谵妄发生率、术后3个月死亡率及总住院时间。
Objective To systematically evaluate the effects of spinal anesthesia(SA)and general anesthesia(GA)on postoperative delirium in patients with hip fracture.Methods Pubmed,Cochranelibrary,Web of science and Embase databases were systematically searched to collect randomized controlled studies on the effects of SA and GA on postoperative delirium in hip fracture surgery from inception to February 2022.Two researchers independently completed literature screening,data extraction and literature quality evaluation,and meta-analysis was performed using RevMan5.4 software.Results A total of 9 randomized controlled studies were included,with 3235 patients,including 1610 patients in the SA group and 1625 patients in the GA group.Meta-analysis showed that there was no significant difference in the incidence of delirium between SA group and GA group at 4 days and 7 days after operation(RR=1.03,1.05,95%CI:0.67-1.60,0.89-1.25,P>0.05).There was no significant difference in the total hospitalization time and the mortality rate at 3 months after operation between the two groups(P>0.05).Conclusion Compared with GA,SA cannot reduce the incidence of delirium at 4 days and 7 days after hip fracture surgery,mortality at 3 months after surgery,and total hospital stay.
作者
黄伟华
张杰
丁声双
秦晓宇
逯晓婷
段蓉蓉
薛建军
HUANG Wei-hua;ZHANG Jie;DING Sheng-shuang;QIN Xiao-yu;LU Xiao-ting;DUAN Rong-rong;XUE Jian-jun(The First Clinical Medical College of Gansu University of Traditional Chinese Medicine,Lanzhou 730000,Gansu,China;Department of Anesthesiology,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,Gansu,China)
出处
《医学信息》
2022年第23期50-54,共5页
Journal of Medical Information
基金
甘肃省科技计划项目(编号:20JR10RA435)
甘肃省科技计划资助项目-重点研发计划(编号:20YF8FA088)。
关键词
椎管内麻醉
全身麻醉
髋部骨折
术后谵妄
Spinal anesthesia
General anesthesia
Hip fracture
Postoperative delirium
