对老年患者手术后痴呆症的Haloperidol的周围手术应用的影响:系统性审查和元分析
Meinv Liu1, Jie Su1, Bei Wang2
1Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, 050051, China.
BMC anesthesiology
|February 2, 2024
概括
利能有效地减少老年患者的术后妄想,没有显著的副作用. 更高的剂量,特别是每天5毫克,对预防妄想产生更大的积极影响.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 基于证据的医学 基于证据的医学
背景情况:
- 手术后痴呆症是老年患者常见和严重的并发症.
- 有效的预防策略对于改善患者结果和降低医疗保健成本至关重要.
研究的目的:
- 系统地审查和分析关于哈洛佩里多尔在预防老年患者手术后狂妄症的疗效的证据.
- 评估哈洛佩里多尔对副作用和住院时间的影响.
主要方法:
- 一个对8项随机对照试验 (RCT) 的元分析,涉及1569名患者.
- 在PubMed,Embase,Cochrane图书馆和CNKI进行了搜索.
- 主要结局:术后妄想的发生率;次要结局:副作用和住院时间.
主要成果:
- 哈洛佩里多尔显著降低了手术后痴呆症的发生率 (OR = 0.62,P = 0.0002).
- 在副作用 (OR = 0.58,P = 0.21) 或住院 (MD = -0.01,P = 0.92) 中没有发现显著差异.
- 亚组分析表明,高剂量 (每日5毫克:OR = 0.40,P = 0.002) 的效果更强.
结论:
- 在老年人中,外科手术期间的哈洛佩里多尔 (haloperidol) 有效地降低了术后狂妄症.
- 利似乎不会引起显著的额外副作用.
- 较高剂量的哈洛佩里多尔 (每天5毫克) 显示出对妄的更明显的预防作用.
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