右美托咪定对老年患者全麻术后认知功能障碍的Meta分析

目的：采用循证医学的方法系统评价右美托咪定在老年患者全麻术后认知功能障碍的影响。方法计算机检索Cochrane、PubMed、Medline、知网、维普、万方数据库，均从建库到2015年7月发表的文献，对符合纳入与排除标准的研究进行资料提取，并采用RevMan 5.2软件进行Meta分析。结果最终纳入13个随机对照试验，共计854例患者。Meta分析结果显示：术后1 d右美托咪定组简易精神状态评价量表(MMSE评分)高于对照组，差异有统计学意义(P<0.05)；右美托咪定组术后1 d POCD的发生率明显低于对照组(P<0.05)，差异有统计学意义。结论老年患者全麻术中使用右美托咪定，能有效改善患者术后认知功能障碍，降低POCD的发生率。

Effects of dexmedetomidine on postoperative cognitive dysfunction in elderly patients undergoing general ;anesthesia:a meta-analysis

Objective To systematically evaluate the effect of dexmedetomidine on postoperative cognitive dysfunction (POCD) in elderly patients undergoing general anesthesia. Methods The randomized controlled trials (RCTs) about the effect of dexmedetomidine on postoperative cognitive dysfunction in elderly patients undergoing gener-al anesthesia were searched in Cochrane library, PubMed, Medline, CNKI, VIP, WanFang databases to July, 2015. Liter-ature were screened according to the the inclusion and exclusion criteria. Then meta-analysis was performed using Rev-Man 5.2. Results A total of 13 RCTs involving 854 patients were enrolled. The results of meta-analysis indicated that the mini mental state examination (MMSE) score at postoperative 1 d in dexmedetomidine group was significantly high-er than the control group (P<0.05). The incidence of POCD at postoperative 1 d in dexmedetomidine group was signifi-cantly lower than the control group, with statistically significant difference (P<0.05). Conclusion Dexmedetomidine can effectively improve cognitive dysfunction after surgery, and reduce the incidence of POCD in elderly patients. It is worthy to be applied and popularized.