标题：右美托咪啶与咪达唑仑对老年患者术后谵妄影响的系统评价

      作者：周 俊 1，王 龙 1，郭 毅 2，周 芹 1
    (1.武汉大学人民医院麻醉科，湖北 武汉 430061；
2.武汉大学公共卫生学院流行病学教研室，湖北 武汉 430071)

      卷次： 2015年26卷2期

      【摘要】 目的 系统评价右美托咪定和咪达唑仑对老年患者术后谵妄的影响。方法 计算机检索
PubMed、SCI、EMbase、The Cochrane Library、CNKI、CBM、WanFang Data和VIP等数据库，全面收集右美托咪
啶和咪达唑仑麻醉对老年患者术后谵妄影响的随机对照试验(RCT)，检索时限均为建库至 2013年 12月。由
两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后，采用RevMan 5.2软件进行Meta分
析。结果 纳入 6个RCT，共 170例老年患者。Meta分析结果显示：与咪达唑仑组比较，经右美托咪定诱导
后，右美托咪定组的谵妄发生率低于咪达唑[RR=0.17，95%CI (0.09，0.30)，P<0.000 01]。结论 咪达唑仑在老
年患者术后发生谵妄率高于右美托咪啶。但鉴于纳入研究较少且样本量小，特别是质量不高，建议临床上开展
大样本、多中心、高质量的随机对照试验进一步论证。

      【关键词】 右美托咪啶；咪达唑仑；老年患者；谵妄；系统评价

      【中图分类号】 R619 【文献标识码】 A 【文章编号】 1003—6350（2015）02—0277—04


Effect of Dexmedetomidine and Midazolam on postoperitive delirium in elderly patients: a systematic review.
ZHOU Jun 1, WANG Long 1, GUO Yi 2, ZHOU Qin 1, 1.
Department of Anesthesiology, People's Hospital of Wuhan
University, Wuhan 430061, Hubei, CHINA; 2. Department of Epidemiology, School of Public Health of Wuhan University,
Wuhan 430071, Hubei, CHINA

【Abstract】 Objective To evaluate the effect of Dexmedetomidine and Midazolam on postoperitive delir-
ium in elderly patients by Meta-analysis. Methods Trials were collected through searches of PubMed, SCI, EM-
base, the Cochrane Library, CNKI, CBM, VIP and Wanfang databases (From the date of establishment of the data-
bases to December 2013) for randomized controlled trials (RCT) on the effect of Dexmedetomidine and Midazol-
am on postoperitive delirium in elderly patients. The included studies were evaluated with criteria by two research-
ers independently and the extracted data were analyzed by RevMan 5.2. Results Six RCT studies involving 170
old patients met the inclusion criteria．The results of meta-analysis showed that，compared with the Midazol-
am-treated patients, the prevalence of delirium was lower in Dexmedetomidine-treated patients [RR=0.17, 95%CI
(0.09, 0.30), P<0.000 01]. Conclusion The incidence of delirium in Dexmedetomidine-treated patients is lower
than that in the Midazolam-treated patients. However, due to the few included RCTs and small samples, especially the
lower quality of included RCTs, more large-samples, high-quality RCTs are required for further verify.

      【Key words】 Dexmedetomidine; Midazolam; Elderly patients; Delirium; Systematic review