在接受重大头癌手术的患者中出现术后妄想的危险因素:元分析
Jiaqi Sun1, Ying Ji, Jingsi Huang
1Author Affiliations: Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology (Ms Sun), School of Nursing (Mss Ji and Huang) and Department of Pediatric Dentistry, School and Hospital of Stomatology (Mrs Zhao), China Medical University, Shenyang.
在头癌 (HNC) 患者的手术后妄 (POD) 影响15.44%. 关键的危险因素包括老年,男性性别,吸烟史,精神疾病和特定的临床指标.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 麻醉学 麻醉学
- 精神病学是一个精神病学.
背景情况:
- 手术后妄 (POD) 是经过大规模手术后的严重并发症,特别是在头癌 (HNC) 患者中.
- 确定可修改的POD风险因素对于制定有针对性的干预措施来减少其发生率和影响至关重要.
研究的目的:
- 在接受头癌 (HNC) 手术的患者中,系统地审查和分析影响术后妄想 (POD) 的因素.
- 为了确定在HNC手术后患上妄想的高风险个体.
主要方法:
- 对2023年6月之前发表的研究,在主要数据库 (PubMed,EMBASE,Scopus,OVID,Cochrane Library) 进行了全面的文献搜索.
- 系统审查和元分析遵循PRISMA指南,使用纽卡斯尔-太华尺度评估研究质量.
- 计算了聚合赔率比率和平均差异,以估计各种因素与POD的关联.
主要成果:
- 该审查包括17项研究,包括4188名HNC患者,POD综合流行率为15.44%.
- 确定了八个POD的显著风险因素:年龄>70岁,男性性别,吸烟史,精神疾病史,美国麻醉学会 (ASA) 评分,低白蛋白水平,术后失眠和流体摄入.
- 这些因素包括6个手术前,1个手术内,1个术后预测因素.
结论:
- 该研究确定了与HNC患者POD相关的8个关键因素,提供了对术前,术后和术后影响的见解.
- 这些发现为临床实践提供了有价值的参考,旨在改善患者的心理状态,并指导开发HNC中POD的有效治疗干预措施.
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