摘要
目的系统评价右美托咪啶对老年患者心脏手术疗效的影响。方法检索PubMed、Embase、Ovid、Web of Science、中国知网、万方数据库及维普数据库中关于老年患者心脏手术中使用右美托咪啶的临床对照研究。由2名研究人员独立对纳入文献进行数据提取及文献质量评价。采用RevMan 5.3对提取数据进行Meta分析。结果最终纳入10项研究,共2072例患者。Meta分析结果显示,右美托咪啶组术后谵妄发生率、手术死亡率均明显低于对照组(RR=0.77、0.40,95%CI:0.63~0.95、0.17~0.91,Z=2.46、2.18,P<0.05),术后机械通气时间明短于对照组(WMD=-2.07,95%CI:-2.73~-1.41,Z=6.13,P<0.01),但两组患者术后ICU住院时间以及术后低血压、心动过缓发生率的差异均无统计学意义(P>0.05)。结论右美托咪啶可减少老年心脏外科手术患者术后谵妄的发生率,并能降低手术死亡率及缩短机械通气时间,但对于术后ICU住院时间、术后低血压和术后心动过缓的发生率无显著影响。
Objective To systematically evaluate the efficacy of dexmedetomidine in elderly patients undergoing cardiac surgery.Methods Clinical controlled trials in PubMed,Embase,Ovid,Web of Science,CNKI,Wanfang database and VIP database were retrieved.Two researchers independently extracted data and evaluated the quality of the included literature.A meta-analysis was performed on the extracted data by RevMan 5.3.Results A total of 2072 patients in 10 studies were included.The results of the meta-analysis showed that the incidence of postoperative delirium and the operative mortality in dexmedetomidine group were significantly lower than that in control group(RR=0.77,0.40;95%CI:0.63-0.95,0.17-0.91;Z=2.46,2.18;P<0.05),and the postoperative mechanical ventilation time was shorter than that in control group(WMD=-2.07,95%CI:-2.73--1.41,Z=6.13,P<0.01).However,there were no significant differences in postoperative ICU stay,postoperative hypotension and postoperative bradycardia between the two groups(P>0.05).Conclusion Dexmedetomidine can reduce the incidence of postoperative delirium,postoperative mortality and mechanical ventilation time in elderly cardiac surgery patients,but has no significant effect on postoperative ICU stay,incidence of postoperative hypotension,and postoperative bradycardia.
作者
史绿儿
任奇
沈杭霞
Shi Lyu’er;Ren Qi;Shen Hangxia(School of Nursing,Hangzhou Medical College,Hangzhou 310053,China;Intensive Care Unit,Zhejiang Hospital,Hangzhou 310013,China)
出处
《中华老年病研究电子杂志》
2023年第1期34-40,共7页
Chinese Journal of Geriatrics Research(Electronic Edition)
作者简介
通信作者:任奇,Email:wujieping1917@163.com
