贵州医科大学 麻醉与心脏电生理课题组
翻译：赵游霄 编辑：赵游霄 审校：曹莹
背景：
术后谵妄（POD）会对患者术后康复产生重大影响，会导致患者病情恶化、住院时间延长以及可能出现长期的认知功能衰退。本研究评估了术中脑电图（EEG）模式对成人术后谵妄的预测价值。
方法：
本次系统综述及荟萃分析遵循了 PRISMA 和 Cochrane 手册的指导原则。通过使用 PubMed、Medline 和 CENTRAL 数据库进行了全面的文献检索，重点研究了成人患者术中原发性脑电图信号分析。主要结果是爆发抑制型脑电图模式与术后谵妄发展的关系。
结果：
在最初确定的 435 篇文章中，有 19 项研究共涉及 7229 名患者被纳入了系统性综述，其中 10 项研究被纳入了荟萃分析（涉及 3705 名患者）。在表现出爆发抑制现象的患者中，POD 的发生率为 22.1%，而没有这种脑电图模式的患者中这一比例为 13.4%（p = 0.015）。此外，爆发抑制持续时间的延长与 POD 发生的可能性增加有关（p = 0.016）。有趣的是，爆发抑制的比例与 POD 没有显著关联。
结论：
这项研究显示，在存在爆发抑制模式的情况下，发生术后谵妄的相对风险增加了 41%。这些结果强调了术中脑电图监测在预测老年患者术后谵妄方面的临床意义，表明其在预防策略中可能具有重要作用。
原始文献：
Likhvantsev V, Berikashvili L, Smirnova A, et al. Intraoperative electroencephalogram patterns as predictors of postoperative delirium: a systematic review and meta-analysis [J]. ., 2024.
Intraoperative electroencephalogram patterns as predictors of postoperative delirium: a systematic review and meta-analysis
Background ：
Postoperative delirium (POD) significantly affects patient outcomes after surgery, leading to increased morbidity, extended hospital stays, and potential long-term cognitive decline. This study assessed the predictive value of intraoperative electroencephalography (EEG) patterns for POD in adults.
METHODS:
This systematic review and meta-analysis followed the PRISMA and Cochrane Handbook guidelines. A thorough literature search was conducted using PubMed, Medline, and CENTRAL databases focusing on intraoperative native EEG signal analysis in adult patients. The primary outcome was the relationship between the burst suppression EEG pattern and POD development.
Results ：
From the initial 435 articles identified, 19 studies with a total of 7,229 patients were included in the systematic review, with 10 included in the meta-analysis (3,705 patients). In patients exhibiting burst suppression, the POD incidence was 22.1% vs. 13.4% in those without this EEG pattern (p=0.015). Furthermore, an extended burst suppression duration associated with a higher likelihood of POD occurrence (p = 0.016). Interestingly, the burst suppression ratio showed no significant association with POD.
Conclusions：
This study revealed a 41% increase in the relative risk of developing POD in cases where a burst suppression pattern was present. These results underscore the clinical relevance of intraoperative EEG monitoring in predicting POD in older patients, suggesting its potential role in preventive strategies.
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