术中脑氧饱和度监测预测脊柱手术患者术后 谵妄的有效性：系统评价与Meta分析

Efficacy of Intraoperative Cerebral Oxygen Saturation Monitoring in Predicting Postoperative Delirium in Patients Undergoing Spine Surgery: A Systematic Review and Meta-Analysis

摘要: 目的：系统评价术中脑氧饱和度监测预测脊柱手术患者术后谵妄的有效性，明确其临床价值与研究争议，为围术期脑功能保护提供参考。方法：检索相关中英文数据库，对术中脑氧饱和度与脊柱手术术后谵妄的关联性研究、监测技术、危险因素、病理生理机制等进行系统梳理，分析现有证据的一致性与局限性，并总结Meta分析的关键要点。结果：术中脑氧饱和度可实时反映脑氧供需平衡，理论上对术后谵妄具有预测潜力，但脊柱手术领域高质量直接证据不足，rSO₂阈值、监测方案、谵妄评估标准不统一，研究结论存在争议。现有证据尚不足以支持其作为独立预测指标。结论：术中脑氧饱和度监测可用于脊柱手术患者脑低氧事件识别与风险分层，但单独用于预测术后谵妄的效能有限。推荐采用多模态脑功能监测，未来需开展大样本、标准化研究以明确其预测价值。

Abstract: Objective: To systematically evaluate the efficacy of intraoperative cerebral oxygen saturation monitoring in predicting postoperative delirium (POD) in patients undergoing spine surgery, clarify its clinical value and research controversies, and provide a reference for perioperative cerebral function protection. Methods: Relevant Chinese and English databases were retrieved to systematically sort out the correlation studies, monitoring techniques, risk factors and pathophysiological mechanisms between intraoperative cerebral oxygen saturation and POD after spine surgery, analyze the consistency and limitations of existing evidence, and summarize the key points of meta-analysis. Results: Intraoperative cerebral oxygen saturation can reflect the balance of cerebral oxygen supply and demand in real time, and theoretically has predictive potential for POD. However, there is a lack of high-quality direct evidence in the field of spine surgery, the rSO₂ threshold, monitoring protocol and delirium assessment criteria are not unified, and research conclusions are controversial. Existing evidence is insufficient to support it as an independent predictor. Conclusion: Intraoperative cerebral oxygen saturation monitoring can be used for the identification of cerebral hypoxia events and risk stratification in spine surgery patients, but its efficacy in predicting POD alone is limited. Multimodal cerebral function monitoring is recommended, and large-sample and standardized studies are needed in the future to clarify its predictive value.