在接受非神经外科手术的老年患者的认知功能障碍在手术后的立即时期:系统性审查
Pinyapat Kitthanyateerakul1, Thitipong Tankumpuan1, Patricia M Davidson2
1Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Nursing open
|August 27, 2024
概括
这一系统性审查确定了老年人进行非神经外科手术后认知功能障碍的关键风险因素. 了解这些因素有助于制定短期恢复的预防策略.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
背景情况:
- 手术后认知功能障碍 (POCD) 是老年人非神经外科手术后的一个重大问题.
- 早期识别风险因素对于减轻POCD和改善患者结果至关重要.
研究的目的:
- 在非神经外科手术和麻醉后七天内,系统地审查和确定与老年患者的术后认知功能障碍相关的危险因素.
- 为制定有针对性的预防和治疗策略提供见解.
主要方法:
- 按照PRISMA 2020指南进行系统审查.
- 在6个主要数据库 (PubMed,EMBASE,Scopus,Ovid,MEDLINE,Science Direct) 进行文献搜索,查找2018年1月至2024年1月间发表的研究.
- 使用约翰霍普金斯护理基于证据的实践证据评级表进行研究评估.
主要成果:
- 包括19项研究,POCD患病率在接受非神经外科手术的老年人中从19%到64%不等.
- 鉴定出的风险因素被分类为手术前 (年龄,教育,营养不良,生物标志物,并发症),手术内 (持续时间,失血,麻醉类型) 和术后 (生物标志物,疼痛).
结论:
- 年龄,并发症,麻醉和术后疼痛是非神经外科手术后老年人POCD的重要危险因素.
- 结果可以指导医疗保健提供者评估和管理POCD,旨在改善短期术后康复.
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