老年术后认知功能障碍及右美托咪啶在其治疗中的作用  

Elderly postoperative cognitive dysfunction and effect of Dexmedetomidine in it

作　　者：余德华[1] 

机构地区：[1]浙江省绍兴市人民医院麻醉科,浙江绍兴312000

出　　处：《中国医药导报》2015年第6期164-168,共5页China Medical Herald

摘　　要：术后认知功能障碍(POCD)是老年患者术后常见的中枢神经系统并发症,表现为记忆力、注意力和计算能力的减退。POCD可致患者康复延迟、住院天数延长及医疗费用增加等,严重时甚至影响患者出院后的生活质量,认识和分析POCD已成为当今麻醉管理的重要课题。POCD是多种影响因素共同作用的结果,评估方法较多且相对主观,没有标准统一的评估,目前虽已有大量动物实验及临床研究,但其发病机制仍不明确。因此全面认识和分析POCD发病机制的进展情况,进一步探讨其预防和治疗方法,具有重要的临床和社会意义。右美托咪定(DEX)是一种新型高效高选择性的α2-受体激动剂,具有镇静镇痛,抗交感作用,抑制应激反应,抑制炎症作用,且不抑制呼吸功能,广泛应用于麻醉重症监护领域。近年来,越来越多的研究表明DEX可改善老年认知功能,降低POCD的发病率。本文就POCD及DEX在老年人POCD治疗中的作用作一综述。Postoperative cognitive dysfunction（POCD） is a subtle impairment of memory,concentration,and speed of information processing. It is a frequent complication following surgery and mainly seen in the elderly. It can have a debilitating effect on patients＇ recovery and future prognosis,such as longer hospital stayand extra cost, or even dent of quality of life after discharge. POCD has made the attention of many scholars, becoming an important subject for anaesthetist to study and analyse. There are a lot of factors resulting in POCD and many assessment methods, with no standard evaluation. Although there are a large number of animal and clinical research, the pathogenesis is still unclear.Therefore, a comprehensive analysis of the pathogenesis about the development of POCD and discussing the method of prevention and treatment have an important clinical and social significance. Dexmedetomidine（DEX） is a new and efficient α2-highly selective receptor agonist, has sedative analgesic, anti-sympathetic, inhibiting the stress response, inhibit inflammation, does not inhibit the respiratory function, widely used in the field of anesthesia in intensive care. In recent years, more and more studies show that DEX may improve cognitive function in the elderly, reduce the incidence of POCD. This paper will review the influence of DEX on POCD in the elderly application

关 键 词：术后认知功能障碍 发病机制 麻醉 右美托咪啶 

分 类 号：R641[医药卫生—外科学]