目的

对肺移植受者术后谵妄影响因素进行范围综述,为精准干预其术后谵妄提供参考和借鉴。

方法

系统检索中国知网、万方数据库、维普数据库、中国生物医学文献服务系统、PubMed、Web of Science、The Cochrane Library、CINAHL、Embase 数据库及Open Grey 数据库,检索时限为建库至2023 年12 月。 由2 名研究者独立筛选文献和提取数据,并对纳入文献进行汇总和分析。

结果

共纳入8 篇文献,肺移植受者术后谵妄发生率为23.5%～51.9%,影响因素包括社会人口学因素(年龄、体质指数)、疾病因素(肺部原发疾病、肺分配系统评分、查尔森合并症指数、移植前认知功能、衰弱状态和术后原发性移植物功能障碍)、手术因素(术中平均动脉压、脑灌注压、乳酸水平和供肺冷缺血时间)、治疗因素(苯二氮卓类及精神药物的使用、机械循环支持的使用、机械通气持续时间)。

结论

肺移植受者术后谵妄发生率较高,且与多种影响因素有关。 未来可借鉴其他实体器官移植术后谵妄研究,开展大样本前瞻性研究,进一步探索肺移植受者术后谵妄的影响因素。

Objective

To provide a scoping review of the factors affecting postoperative delirium in lung transplant recipients, providing reference for precise intervention of postoperative delirium in lung transplant recipients.

Methods

A systematic search of China National Knowledge Infrastructure, Wangfang Data, VIP database, Chinese Biomedical Literature Service System,PubMed, Web of Science, The Cochrane Library, CINAHL, Embase database and Open Grey database, was conducted with a time frame of the construction of the database to December 2023.Literature was screened and data were extracted independently by 2 investigators, and the included literature was summarised and analysed.

Results

A total of 8 papers were included. The incidence of postoperative delirium in lung transplant recipients ranged from 23.5% to 51.9%, and the influencing factors included sociodemographic factors (age and body mass index), disease factors (primary lung disease, lung allocation system score, Charlson comorbidity index, pre-transplant cognitive function,pretransplant frailty and postoperative primary graft dysfunction), and surgical factors (intraoperative mean arterial pressure, cerebral perfusion pressure, lactate level, donor lung cold ischemia time), and therapeutic factors (use of benzodiazepines and psychotropic drugs, use of mechanical circulatory support and duration of mechanical ventilation).

Conclusions

The incidence of postoperative delirium in lung transplant recipients is high and is associated with multiple influencing factors. In future studies, a prospective study with a large sample could be conducted to further explore the influencing factors of postoperative delirium in lung transplant recipients, drawing on other solid organ transplantation postoperative delirium studies.