德克斯梅德托米丁对胃肠道癌症患者的术后认知功能的影响:随机对照试验的元分析
Xiaoxia Zheng1, Yang Lan1, Lesi Chen1
1Department of Anesthesia, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
德克斯梅德托米丁 (DEX) 改善了认知功能,并减少了手术后的认知功能障碍 (POCD) 在胃肠道癌症患者接受手术. 为了获得明确的证据,还需要进一步的高质量试验.
科学领域:
- 麻醉学和外科手术期间的医学.
- 在瘤学瘤学.
- 神经科学是一个神经科学.
背景情况:
- 手术后的认知功能障碍 (POCD) 是一项严重的担忧,对患者进行激进手术 (RS) 的胃肠道癌症 (GICs).
- 德克斯梅德托米丁 (DEX) 是一种具有潜在神经保护性能的麻醉剂.
研究的目的:
- 系统地评估DEX对微型精神状态考试 (MMSE) 成绩的影响.
- 为了评估在GIC患者中POCD的发病率,这些患者接受了RS与DEX的管理.
主要方法:
- 12项随机对照试验 (RCT) 的元分析,涉及881名患者.
- 基于异质性的固定效应或随机效应模型的数据合成.
- 使用Cochrane协作工具进行质量评估,通过Egger测试进行出版偏差评估.
主要成果:
- 在术后的1,2,3和7天,DEX显著改善了MMSE得分.
- 观察到DEX对POCD发病率的保护作用.
- 在子组分析中没有发现异质性的来源;没有发现出版偏差.
结论:
- 在接受RS的GIC患者中,DEX对认知功能产生保护作用.
- 建议进行高质量的,大规模的RCT来确认这些发现,并提供更确定的证据.
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