脊柱手术后认知功能障碍和术后谵妄
Cognitive dysfunction and postoperative delirium after spinal surgery
刘东 1陶庆宇 1朱海娟 2余骏马1
作者信息
- 1. 安徽医科大学第三附属医院,合肥市第一人民医院麻醉科,合肥 230061
- 2. 安徽医科大学附属妇幼保健院麻醉科,合肥 230001
- 折叠
摘要
术后认知功能障碍与术后谵妄是围手术期神经认知功能障碍(perioperative neurocognitive dysfunction,PND)的2种主要表现形式.它们在脊柱手术后较为常见,并对患者的术后康复及生活质量产生显著的负面影响.除了年龄和教育程度等已知风险因素外,术中低血压和低体温亦是PND发生的重要诱因.其潜在的病理机制可能涉及神经炎症反应的增强和神经递质水平的降低.此外,某些麻醉药物(如右美托咪定和艾司氯胺酮)已被证实可能通过抑制炎症过程,对预防PND具有潜在的积极作用.
Abstract
Postoperative cognitive dysfunction and postoperative delirium are 2 major manifestations of perioperative neurocognitive dysfunction(PND).They are relatively common after spinal surgery and have a significant negative impact on the patient's postoperative recovery and quality of life.In addition to known risk factors such as age and educational level,intraoperative hypotension and hypothermia are also important triggers for the occurrence of PND.The underlying pathological mechanisms may involve an enhanced neuroinflammatory response and reduced neurotransmitter levels.Moreover,certain anesthetics,such as dexmedetomidine and esketamine,have been shown to potentially prevent PND by inhibiting the inflammatory process.
关键词
脊柱手术/术后认知功能障碍/术后谵妄/神经炎症Key words
spine surgery/postoperative cognitive dysfunction/postoperative delirium/neuroinflammation引用本文复制引用
基金项目
安徽省卫生健康委科研项目(2022-145)
Research Project of Anhui Health Committee,China(2022-145)
出版年
2024
国家科技期刊平台
NSTL
万方数据