术后认知功能障碍的危险因素在接受动脉内关节切除术的患者中:更新的元分析
Jinhua He1, Ran Duan1, Peng Qiu2
1Department of Anesthesiology, Hebei General Hospital, Shijiazhuang, China.
Journal of cardiothoracic surgery
|November 10, 2023
概括
手术后认知功能障碍 (POCD) 影响了19%的 carotid endarterectomy (CEA) 后患者. 过度输血,内动脉狭窄和糖尿病是关键的危险因素,而手术前使用他类药物可能有保护作用.
科学领域:
- 神经科学是一个神经科学.
- 心血管外科心血管外科
- 医学统计 医学统计
背景情况:
- 手术后认知功能障碍 (POCD) 是手术后的一个担忧.
- Carotid Endarterectomy (CEA) 是一种常见的手术,用于预防中风.
- 了解CEA后的POCD发病率和风险因素对于患者的治疗结果至关重要.
研究的目的:
- 为了确定经过CEA后的POCD发病率.
- 为了确定与POCD发展相关的重大风险因素.
- 为POCD预防和治疗策略提供科学基础.
主要方法:
- 对2022年10月之前发表的相关研究进行元分析.
- 在Pubmed/MEDLINE,Cochrane和Embase数据库中进行的搜索.
- 随机效应模型用于估计赔率比率和平均差异;使用纽卡斯尔-太华尺度评估研究质量.
主要成果:
- 在CEA后,POCD的综合发病率为19%.
- 确定的危险因素包括高 perfusion 和内动脉 (ICA) 狭窄.
- 手术前使用他类药物与POCD风险降低有关;在手术后1个月糖尿病风险增加.
结论:
- 过和ICA狭窄程度是经CEA后POCD的重要危险因素.
- 糖尿病是经过CEA一个月内发展POCD的一个显著风险因素.
- 手术前使用他类药物可以作为CEA后对POCD的保护措施.
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