摘要
目的 分析老年脊柱手术患者发生术后谵妄的危险因素，为临床预防POD的发生提供依据。方法 计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Cochrane Library、PubMed、Web of Science、Embase数据库，检索时限为建库至2022年2月1日，使用RevMan 5.3进行Meta分析。结果 共纳入15篇文献，累计5098例样本，POD的发生率为14%[95%CI(0.11,0.16)]；Meta分析结果包括16项相关危险因素，具有统计学意义的危险因素包括合并颈椎手术（OR=1.29）、高血压病（OR=3.46）、脑血管病（OR=1.48）、使用阿片类药物（OR=2.56）、年龄>70岁（OR=4.50）、术前焦虑（OR=2.94）、ASA评分≥3（OR=5.33）、肺部疾病（OR=2.01）、术后疼痛（OR=3.17）、术后发热（OR=1.38）、年龄（OR=1.27）与POD的发病相关。结论 老年脊柱手术患者发生术后谵妄的发病率高，合并颈椎手术、高血压病、脑血管病、使用阿片类药物、年龄>70岁、术前焦虑、ASA评分≥3、肺部疾病、术后疼痛、术后发热、年龄增长的老年脊柱手术患者易发生POD，护理人员应充分关注该类患者。
关键词： 脊柱；谵妄；发病率；危险因素；Meta分析
Abstract
Objective To analyze the main risk factors of postoperative delirium in elderly patients undergoing spinal surgery, and to provide evidence for clinical prevention of POD. Methods We searched databases including CNKI, Wanfang, VIP, CBM, Cochrane Library , PubMed ,Web of Science, and Embase, from inception to February 2022. Rev Man 5.3 software was used for meta-analysis. Results A total of 15articles were included, including 5098 samples. the incidence of POD was 14%[95%CI(0.11,0.16)]. The results of meta-analysis included 16 related risk factors, with statistically significant risk factors including combined cervical spine surgery (OR=1.29), hypertension (OR=3.46), cerebrovascular disease (OR=1.48) ,opioid use (OR=2.56) ,age>70 years old (OR=4.50) ,preoperative anxiety (OR=2.94) ,ASA score≥3(OR=5.33) ,Pulmonary disease (OR=2.01) ,postoperative pain (OR=3.17) ,postoperative fever (OR=1.38) ,Age (OR=1.27). Conlusion The incidence of postoperative delirium in elderly spinal surgery patients is high, combined with cervical surgery ,hypertension, cerebrovascular disease ,opioid use, age>70 years old, preoperative anxiety ,ASA score ≥3 ,Pulmonary disease ,postoperative pain ,postoperative fever, Elderly spinal surgery patients with aging are prone to POD, nursing staff should pay full attention to this patient .
Key words： The spine; Delirium; Incidence of a disease.；Risk factors; Meta analysis
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