术后低血压对术后妄想的影响:元分析和系统性审查
Xiaowei Yin1, Huolin Zeng1, Qian Li1
1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Frontiers in medicine
|January 22, 2026
概括
术内低血压 (IOH) 显著增加了术后痴呆症 (POD) 的风险. 需要标准化定义来证实这种关联,因为目前的证据显示了相当大的异质性.
科学领域:
- 麻醉学和外科手术期间的医学.
- 关键护理医学 关键护理医学
- 老年医学 老年医学
背景情况:
- 手术后痴呆症 (POD) 是一种常见的并发症,与患者不良后果有关.
- 术内低血压 (IOH) 和POD之间的联系尚未得到充分证实.
- 澄清这种关联对于改善患者安全和手术结果至关重要.
研究的目的:
- 系统地审查和元分析手术内低血压 (IOH) 和术后妄想 (POD) 之间的关联.
- 调查研究IOH和POD的研究中异质性的潜在来源.
主要方法:
- 在四个主要数据库 (PubMed,EMBASE,Cochrane Library,Web of Science) 进行了全面的搜索,截至2025年6月14日.
- 包括的研究包括随机对照试验 (RCT) 和观察性研究,评估IOH作为成人手术患者POD的预测因素.
- 风险比率 (RR) 和赔率比率 (OR) 使用随机效应模型进行计算.
主要成果:
- 包括30项研究,18项正在进行元分析.
- 在临床试验 (RR: 1.89) 和观察性研究 (OR: 2.48) 中,术后低血压 (IOH) 与术后狂妄症 (POD) 的风险增加显著相关.
- 亚组分析表明,通过绝对值或平均动脉压 (MAP) 定义的IOH显示出更高的POD风险,定义值被确定为异质性的关键来源 (p=0.048).
结论:
- 这一元分析证实了手术内低血压 (IOH) 与术后狂妄症 (POD) 风险增加之间的显著关联.
- 方法上的异质性,特别是IOH的定义,限制了这些发现的确定性.
- 建议使用标准化定义进行进一步的研究,以巩固证据基础.
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