右美托咪定对老年结直肠癌手术患者术后认知功能影响的Meta分析

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【中图分类号】 R971+.2 【文献标识码】A

【Abstract】 Objective To systematically review the effect of dexmedetomidine on the cognitive function of elderly patients after general anesthesia for colorectal cancer surgery. MethodsPubMed，Web ofScience，Embase，Cochrane Library，CNKI，WanFang Data， VIP，and SinoMed databases were electronically searched to collct randomized controlled trials （RCTs）

on the efect of dexmedetomidine on the cognitive function of elderly patients after general anesthesia for colorectal cancer surgery from inception to June 30，2025.Two reviewers independently screened literature， extracted data，and assessed the risk of bias of included studies.The Meta-analysis was performed by using RevMan 5.3 software.Results A total of 13 RCTs involving 1，324 patients were included.The Meta-analysis showed that compared with 0.9% sodium chloride injection or blank control， dexmedetomidine can reduce the incidence of postoperative cognitive dysfunction [OR -0.21 ， 95%CI （0.16， 0.28）， P<0.001. ]，interleukin-6 levelson postoperative 1d [MD 1= -18.19， 95%CI （-26.73， -9.64）， P<0.001 ]， tumor necrosis factor-a level on postoperative 1 d [MD ⊨ -16.68， 95%CI （-31.57， -1.79）， P=0.03 l，and increase postoperative outcomes 1 d [MD 1=4.14 ， 95%CI （3.27， 5.01）， P<0.001 ]，3d[MD 1=3.80 ， 95%CI （2.91， 4.69）， P<0.001 ]scoreof theMini-Mental State Examination （MMSE）.The incidence of adverse reactions in the dexmedetomidine group was significantly lower than that in the control group [OR .=0.34 ， 95%CI （0.12， 0.95）， P=0.04 ].Conclusions Current evidence shows that the intraoperative use of dexmedetomidine in elderly patients undergoing general anesthesia for colorectal cancer surgery can reduce the incidence of postoperative cognitive impairment in patients and has a neuroprotective effect on the nervous system， which may improve their postoperative cognitive impairment. Due to the limited qualityand quantity of the included studies， more further large-scale multicenter studies are required to verify the above conclusion.

【Keywords】Dexmedetomidine; Colorectal neoplasms; Postoperative cognitive dysfunction; Meta·analysis; Systematic review

结直肠癌（colorectalcancer，CRC）是临床最常见的消化道恶性肿瘤之一，其发病率居全球所有癌症的第3位、病死率居第2位。（剩余12664字）