[1]李洁,蒋运兰,廖诗沁,等.老年人围术期睡眠障碍与术后谵妄发生风险关系的Meta分析[J].军事护理,2023,40(06):96-100.[doi:10.3969/j.issn.2097-1826.2023.06.023]
　LI Jie,JIANG Yunlan,LIAO Shiqin,et al.The Relationship Between Perioperative Sleep Disorders and the Risk of Postoperative Delirium Among the Elderly:A Meta-Analysis[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(06):96-100.[doi:10.3969/j.issn.2097-1826.2023.06.023]
点击复制

老年人围术期睡眠障碍与术后谵妄发生风险关系的Meta分析
分享到：

《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年06期
页码:
96-100
栏目:
循证护理
出版日期:
2023-06-15

文章信息/Info

Title:
The Relationship Between Perioperative Sleep Disorders and the Risk of Postoperative Delirium Among the Elderly:A Meta-Analysis
文章编号:
2097-1826(2023)06-0096-05
作者:
李洁1; 蒋运兰2; 廖诗沁1; 彭寒梅1; 陈曾丽1; 刘明婷1; 卢宇彤1; 刘雅鑫1
(1.成都中医药大学 护理学院,四川 成都 611137; 2.成都中医药大学附属医院 院长办公室,四川 成都 610075)
Author(s):
LI Jie1; JIANG Yunlan2; LIAO Shiqin1; PENG Hanmei1; CHEN Zengli1; LIU Mingting1; LU Yutong1; LIU Yaxin1
(1.School of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,Sichuan Province,China; 2.Office of President,The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan Province,China)
关键词:
老年人;  睡眠障碍;  围术期;  术后谵妄;  Meta分析
Keywords:
the elderly;  sleep disorders;  perioperative period;  postoperative delirium;  Meta-analysis
分类号:
R473.59; R47-05
DOI:
10.3969/j.issn.2097-1826.2023.06.023
文献标志码:
A
摘要:
目的 系统评价老年人围术期睡眠障碍与术后谵妄发生风险的关系。方法 计算机检索Pubmed、Embase、Web of Science、Cochrane Library、CNKI、Wanfang、VIP和Sinomed等数据库中有关老年人围术期睡眠障碍与术后谵妄发生风险关系的相关文献,搜索时间为建库至2022年3月。采用Revman 5.3软件进行Meta分析。结果 共纳入17项研究,涉及5396名患者。Meta分析结果显示,老年人围术期睡眠障碍会增加术后谵妄的发生风险[OR=3.29,95%CI(2.36,4.58),P<0.001]。亚组分析显示,不同研究设计类型、睡眠障碍类型、睡眠障碍发生时间、手术类型、谵妄评估工具均与术后谵妄的发生风险均密切相关。结论 医务人员应重视老年人围术期睡眠障碍对术后谵妄的影响,加强管理和预防。
Abstract:
Objective To systematically evaluate the relationship between perioperative sleep disorders and the risk of postoperative delirium among the elderly.Methods Literature on the relationship between perioperative sleep disorders and the risk of postoperative delirium among the elderly was searched by computer from Pubmed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang,VIP and Sinomed databases.The retrieval period was from the inceptions to March 2022.Meta-analysis was performed using Revman 5.3 software.Results A total of 17 studies were included,with a total sample size of 5 396 patients.Meta-analysis showed that sleep disorders was significantly correlated with postoperative delirium among the elderly[OR=3.29,95%CI(2.36,4.58),P<0.001].Subgroup analysis showed that different study designs,different types of sleep disorders,different onset time of sleep disorders,different types of surgery,and different delirium assessment tools were significantly correlated with the risk of postoperative delirium.Conclusions Medical staff should pay attention to the influence of perioperative sleep disorders on postoperative delirium among the elderly,and strengthen the management and prevention.

参考文献/References:

[1] 王玉茜,张亚文,黄培盈,等.腹腔镜手术老年患者术前痛阈与术后谵妄的相关性[J].临床麻醉学杂志,2022,38(6):665-668.
[2] 黄培,黄丽华.老年病人发生术后谵妄相关危险因素及护理研究进展[J].护理研究,2021,35(9):1631-1635.
[3] 梁迪生,金雁,古晨,等.老年全麻非心脏手术患者术后谵妄的危险因素[J].国际护理学杂志,2022,41(3):423-426.
[4] JIN Z,HU J,MA D.Postoperative delirium:perioperative assessment,risk reduction,and management[J].Br J Anaesth,2020,125(4):492-504.
[5] 陈羽双,杨斯钰,金梦.老年患者睡眠障碍管理的最佳证据总结[J].中华护理教育,2022,19(1):38-43.
[6] WESSELIUS H M,VAN DEN ENDE E S,ALSMA J,et al.Quality and quantity of sleep and factors associated with sleep disturbance in hospitalized patients[J].JAMA Intern Med,2018,178(9):1201-1208.
[7] KING C R,FRITZ B A,ESCALLIER K,et al.Association between preoperative obstructive sleep apnea and preoperative positive airway pressure with postoperative intensive care unit delirium[J/OL].[2022-05-01].https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2764597.DOI:10.1001/jamanetworkopen.2020.3125.
[8] SUNY,JIANG M,JI Y,et al.Impact of postoperative dexmedetomidine infusion on incidence of delirium in elderly patients undergoing major elective noncardiac surgery:a randomized clinical trial[J].Drug Des Devel Ther,2019(13):2911-2922.
[9] 周蓉,刘玥,马正良.术前睡眠障碍在老年术后谵妄中的作用研究进展[J].国际麻醉学与复苏杂志,2022,43(1):63-66.
[10]STANG A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in Meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.
[11]BOSMAK F S,GIBIM P T,GUIMARÀES S,et al.Incidence of delirium in postoperative patients treated with total knee and hip arthroplasty[J].Rev Assoc Med Bras(1992),2017,63(3):248-251.
[12]GUPTA R M,PARVIZI J,HANSSEN A D,et al.Postoperative complications in patients with obstructive sleep apnea syndrome undergoing hip or knee replacement:a case-control study[J].Mayo Clin Proc,2001,76(9):897-905.
[13]HE Z,CHENG H,WU H,et al.Risk factors for postoperative delirium in patients undergoing microvascular decompression[J/OL].[2022-05-02].https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215374.DOI:10.1371/journal.pone.0215374.
[14]HONDA S,FURUKAWA K,NISHIWAKI N,et al.Risk factors for postoperative delirium after gastrectomy in gastric cancer patients[J].World J Surg,2018,42(11):3669-3675.
[15]STRUTZ P K,KRONZER V,TZENG W,et al.The relationship between obstructive sleep apnoea and postoperative delirium and pain:an observational study of a surgical cohort[J].Anaesthesia,2019,74(12):1542-1550.
[16]WANG J,LI Z,YU Y,et al.Risk factors contributing to postoperative delirium in geriatric patients postorthopedic surgery[J].Asia Pac Psychiatry,2015,7(4):375-382.
[17]高志祥,姜义山,龙能吉,等.老年髋关节置换术后患者发生谵妄的危险因素[J].中国组织工程研究,2019,23(32):5097-5102.
[18]FLINK B J,RIVELLI S K,COX E A,et al.Obstructive sleep apnea and incidence of postoperative delirium after elective knee replacement in the nondemented elderly[J].Anesthesiology,2012,116(4):788-796.
[19]HWANG H,LEE K M,SON K L,et al.Incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer[J/OL].[2022-05-02].https://bmccancer.biomedcentral.com/articles/10.1186/s12885-018-4681-2.DOI:10.1186/s12885-018-4681-2.
[20]ROGGENBACH J,KLAMANN M,VON HAKEN R,et al.Sleep-disordered breathing is a risk factor for delirium after cardiac surgery:a prospective cohort study[J/OL].[2022-05-02].https://ccforum.biomedcentral.com/articles/10.1186/s13054-014-0477-1.DOI:10.1186/s13054-014-0477-1.
[21]SIMEONE S,PUCCIARELLI G,PERRONE M,et al.Delirium in ICU patients following cardiac surgery:an observational study[J].J Clin Nurs,2018,27(9-10):1994-2002.
[22]TAFELMEIER M,KNAPP M,LEBEK S,et al.Predictors of delirium after cardiac surgery in patients with sleep disordered breathing[J/OL].[2022-05-02].https://erj.ersjournals.com/content/54/2/1900354.long.DOI:10.1183/13993003.00354-2019.
[23]TODD O M,GELRICH L,MACLULLICH A M,et al.Sleep disruption at home as an independent risk factor for postoperative delirium[J].J Am Geriatr Soc,2017,65(5):949-957.
[24]YAMAGATA K,ONIZAWA K,YUSA H,et al.Risk factors for postoperative delirium in patients undergoing head and neck cancer surgery[J].Int J Oral Maxillofac Surg,2005,34(1):33-36.
[25]ZHANG W Y,WU W L,GU J J,et al.Risk factors for postoperative delirium in patients after coronary artery bypass grafting:a prospective cohort study[J].J Crit Care,2015,30(3):606-612.
[26]郭亮,林飞,于美刚,等.术前睡眠质量对老年患者术后谵妄发生的影响[J].临床麻醉学杂志,2018,34(7):673-677.
[27]李仁华,陈娜,王锷,等.老年患者术前睡眠障碍与术后神经认知恢复延迟的相关性[J].中南大学学报:医学版,2021,46(11):1251-1259.
[28]WANG H,ZHANG L,ZHANG Z,et al.Perioperative sleep disturbances and postoperative delirium in adult patients:a systematic review and Meta-analysis of clinical trials[J/OL].[2022-05-02].https://www.frontiersin.org/articles/10.3389/fpsyt.2020.570362/full.DOI:10.3389/fpsyt.2020.570362.
[29]MILRAD S F,HALL D L,JUTAGIR D R,et al.Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis(CFS/ME)symptoms in women[J].J Neuroimmunol,2016,303(3):43-50.
[30]徐钊,张玉明,杨瑞,等.术前连续髂筋膜间隙阻滞对老年髋部骨折患者围术期睡眠质量及术后谵妄的影响[J].临床麻醉学杂志,2020,36(10):953-957.
[31]KRISTINE Y,NASRALLAH,HOANG T D,et al.Sleep duration and white matter quality in middle-aged adults[J].Sleep,2016,39(9):1743-1747.
[32]TASBIHGOU S R,ABSALOM A R.Postoperative neurocognitive disorders[J].Korean J Anesthesiol,2020,74(1):15-22.
[33]RAVI B,PINCUS D,CHOI S,et al.Association of duration of surgery with postoperative delirium among patients receiving hip fracture repair[J/OL].[2022-05-02].https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2725493.DOI:10.1001/jamanetworkopen.2019.0111.
[34]李瑛,李贤煌,胡燕,等.心脏外科术后患者发生谵妄危险因素的Meta分析[J].解放军护理杂志,2022,39(6):72-76.
[35]FADAYOMI A B,IBALA R,BILOTTA F,et al.A systematic review and Meta-analysis examining the impact of sleep disturbance on postoperative delirium[J].Critical Care Medicine,2018,46(12):1204-1212.
[36]薄晗,刘玥,马正良.术后谵妄诊断方法的研究进展[J].实用老年医学,2020,34(4):410-414.

相似文献/References:

[1]邵雨婷,徐燕.医学类专业学生对老年人态度的研究进展[J].军事护理,2021,38(01):61.[doi:10.3969/j.issn.1008-9993.2021.01.016]
[2]周滢,甘珊,李峥.社区老年人主观认知下降现状及影响因素分析[J].军事护理,2021,38(04):21.[doi:10.3969/j.issn.1008-9993.2021.04.006]
　ZHOU Ying,GAN Shan,LI Zheng.Status Quo of Subjective Cognitive Decline and Its Influencing Factors among Community-Dwelling Elder Adults[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(06):21.[doi:10.3969/j.issn.1008-9993.2021.04.006]
[3]张纯,丁四清,谢建飞,等.老年人阈下抑郁的研究进展[J].军事护理,2021,38(07):74.[doi:10.3969/j.issn.1008-9993.2021.07.019]
[4]杨吉羚,邹圣强,茆敏,等.老年冠心病患者再入院风险预测模型的构建及验证[J].军事护理,2021,38(08):20.[doi:10.3969/j.issn.1008-9993.2021.08.006]
　YANG Jiling,ZOU Shengqiang,MAO Min,et al.Construction and Validation of the Risk Prediction Model for Readmission among Elderly Patients with Coronary Heart Disease[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(06):20.[doi:10.3969/j.issn.1008-9993.2021.08.006]
[5]汪亚男,顾艳荭,谢传桃,等.老年轻度认知功能障碍早期识别最佳循证证据总结[J].军事护理,2021,38(08):55.[doi:10.3969/j.issn.1008-9993.2021.08.015]
　WANG Yanan,GU Yanhong,XIE Chuantao,et al.Summary of Best Evidence on Early Identification of Mild Cognitive Impairment among the Elderly[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(06):55.[doi:10.3969/j.issn.1008-9993.2021.08.015]
[6]刘畅,钱瑾瑜,曾诗颖,等.本森放松训练对食管癌放化疗患者睡眠质量的影响[J].军事护理,2021,38(09):82.[doi:10.3969/j.issn.1008-9993.2021.09.021]
　LIU Chang,QIAN Jinyu,ZENG Shiying,et al.Effects of Benson Relaxation Response on Sleep Quality among Esophageal Cancer Patients Undergoing Chemoradiotherapy[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(06):82.[doi:10.3969/j.issn.1008-9993.2021.09.021]
[7]胡惠菊,郭雪琪,唐启群,等.养老机构老年人跌倒警觉度现状及其影响因素研究[J].军事护理,2021,38(11):17.[doi:10.3969/j.issn.1008-9993.2021.11.005]
　HU Huiju,GUO Xueqi,TANG Qiqun,et al.The Self-Awareness of Falls and Its Correlates among the Elderly in Nursing Home[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(06):17.[doi:10.3969/j.issn.1008-9993.2021.11.005]
[8]李春玉,唐琳熙,金锦珍,等.社区老年人的内在能力及外环境因素对健康老龄化的影响[J].军事护理,2021,38(12):22.[doi:10.3969/j.issn.1008-9993.2021.12.006]
　LI Chunyu,TANG Linxi,JIN Jinzhen,et al.The Influence of Intrinsic Capacity and External Environment on Healthy Aging among Community Elders[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(06):22.[doi:10.3969/j.issn.1008-9993.2021.12.006]
[9]周胜蓝,王雨,温敬冬,等.老年糖尿病膀胱过度活动症患者疾病感知现状及其与生活质量的相关性[J].军事护理,2022,39(01):13.[doi:10.3969/j.issn.1008-9993.2022.01.004]
　ZHOU Shenglan,WANG Yu,WEN Jingdong,et al.Status of Disease Perception in Elderly Diabetic Patients with Overactive Bladder and Its Correlation with the Quality of Life[J].Nursing Journal Of Chinese People's Laberation Army,2022,39(06):13.[doi:10.3969/j.issn.1008-9993.2022.01.004]
[10]刘璟,肖明朝,侯春秀,等.养老机构老年人营养信息获取体验的质性研究[J].军事护理,2022,39(01):55.[doi:10.3969/j.issn.1008-9993.2022.01.014]
　LIU Jing,XIAO Mingzhao,HOU Chunxiu,et al.The Experience of Obtaining Nutrition Information among the Elderly in Pension Institutions: A Qualitative Research[J].Nursing Journal Of Chinese People's Laberation Army,2022,39(06):55.[doi:10.3969/j.issn.1008-9993.2022.01.014]

备注/Memo

备注/Memo:
【 收稿日期 】2022-06-13【 修回日期 】2023-01-18
【 基金项目 】国家科技部“主动健康和老龄化科技应对”重点专项(2020YFC2003104)
【 作者简介 】李洁,护士,硕士在读,电话:028-61800135
【 通信作者 】蒋运兰,电话:028-87783047
更新日期/Last Update: 2023-06-15