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乌司他丁对老年全麻患者术后认知功能障碍的疗效及安全性的系统评价和 Meta 分析方案。

Efficacy and safety of ulinastatin on cognitive dysfunction after general anesthesia in elderly patients: A protocol for systematic review and meta-analysis.

机构信息

Department of Anesthesiology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei province, China.

出版信息

Medicine (Baltimore). 2021 Apr 2;100(13):e24814. doi: 10.1097/MD.0000000000024814.

Abstract

BACKGROUND

With the aging of society, the incidence of diseases increases. And along with the increase of surgery rate, the number of elderly patients with postoperative cognitive dysfunction (POCD) is also increasing. POCD seriously affects the mental state and quality of life of patients and their families. Clinical studies have shown that POCD is closely related to inflammatory reaction, and Ulinastatin can inhibit the inflammatory reaction and reduce the incidence of POCD in elderly patients under general anesthesia. However. the effect of Ulinastatin on POCD in elderly patients under general anesthesia has not been systematically evaluated.

OBJECTIVE

Meta analysis will be used to evaluate the efficacy and safety of Ulinastatin in elderly patients with general anesthesia POCD during perioperative period.

METHODS

We will search China Science and Technology Journal Database Chinese database, China National Knowledge Infrastructure, Wanfang, China biomedical database, PubMed, EMBASE, Cochrane Library and web of science for randomized controlled trials of the effect of Ulinastatin on POCD of elderly patients with general anesthesia from the establishment of the database to November 2020. The 2 researchers will independently screen the literature and conducted quality assessment and data extraction for the included studies, Revman5.3 software will be used for risk assessment and meta analysis.

RESULTS

In this study, the efficacy and safety of Ulinastatin in elderly patients with general anesthesia POCD will be evaluated by the incidence of postoperative cognitive impairment, mini mental state examination (Mini-Mental State Examination [MMSE]), visual regeneration, associative memory score, S100 β protein, tumor necrosis factor α (TNF- α), interleukin 6 (IL-6), IL- 10 inflammatory factors and the incidence of adverse reactions.

CONCLUSION

The use of Ulinastatin in perioperative period can significantly reduce the inflammatory level of elderly patients after general anesthesia, effectively prevent the occurrence of POCD and reduce its incidence.

ETHICS AND DISSEMINATION

The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/GY3V7.

摘要

背景

随着社会老龄化,疾病的发病率增加。随着手术率的提高,老年术后认知功能障碍(POCD)患者的数量也在增加。POCD 严重影响患者及其家属的精神状态和生活质量。临床研究表明,POCD 与炎症反应密切相关,乌司他丁可抑制炎症反应,降低老年全麻患者 POCD 的发生率。然而,乌司他丁对老年全麻患者 POCD 的影响尚未得到系统评价。

目的

采用 Meta 分析评价乌司他丁对老年全麻患者围术期 POCD 的疗效及安全性。

方法

检索中国科技期刊数据库、中国知网、万方、中国生物医学文献数据库、PubMed、EMBASE、Cochrane 图书馆和 Web of Science 自数据库建立至 2020 年 11 月期间关于乌司他丁对老年全麻患者 POCD 影响的随机对照试验。由 2 位研究者独立筛选文献,并对纳入研究进行质量评价和数据提取,采用 Revman5.3 软件进行风险评估和 Meta 分析。

结果

本研究将通过术后认知障碍发生率、简易智力状态检查量表(Mini-Mental State Examination [MMSE])评分、视觉再生、联想记忆评分、S100β蛋白、肿瘤坏死因子-α(TNF-α)、白细胞介素 6(IL-6)、IL-10 炎症因子及不良反应发生率评价乌司他丁对老年全麻患者 POCD 的疗效及安全性。

结论

围术期应用乌司他丁可显著降低老年全麻患者术后炎症水平,有效预防 POCD 的发生,降低其发生率。

伦理与传播

不会公布个人的隐私信息。本系统评价也不会危及参与者的权利。不需要伦理批准。研究结果可能发表在同行评议的期刊上,或在相关会议上传播。

OSF 注册号:DOI 10.17605/OSF.IO/GY3V7。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/628a/8021364/dba45aceddf5/medi-100-e24814-g001.jpg

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