苯二氮类药物与老年股骨颈骨折患者围术期谵妄  

Benzodiazepines and perioperative delirium of femoral neck fractures in elderly

作　　者：栗智 田康[1] 徐刚 李杰[1] LI Zhi;TIAN Kang;XU Gang;LI Jie(Depart-ment of Joint Surgery,The First Affiliated Hospital,Dalian Medical University,Dalian 116021,China)

机构地区：[1]大连医科大学附属第一医院关节外科,辽宁大连116021

出　　处：《中国矫形外科杂志》2022年第6期519-523,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81601901);辽宁省自然科学基金项目(编号:2019-MS-079,2019-BS-079,20170540285)。

摘　　要：谵妄是老年股骨颈骨折患者围术期的常见并发症。目前认为谵妄发病由多因素介导,与多种不良结局密切相关。有临床证据表明,苯二氮䓬类药物能够通过非特异性激活GABAA受体诱发谵妄。然而,苯二氮䓬类药物常被不规范地应用在老年股骨颈骨折患者围手术期管理中,由此引发的谵妄未得到重视。本文从谵妄的病理生理机制、苯二氮䓬类药物与谵妄的关系、老年股骨颈骨折患者谵妄易发的原因及防治策略等方面进行综述,以期为老年股骨颈骨折患者围术期管理提供参考。Delirium is a common perioperative complication in elderly patients with femoral neck fractures,which is currently be⁃lieved due to multiple factors and closely related to adverse outcomes.Many clinical evidences have showed that benzodiazepines induces delirium by non-specific activation of GABAAreceptors,however,the perioperative delirium induced by benzodiazepines in elderly pa⁃tients with femoral neck fractures has not been paid enough attention.In order to provide a reference for perioperative management of elder⁃ly patients with femoral neck fractures,this paper reviews the pathophysiological mechanism of delirium,the relationship between benzodi⁃azepines and delirium,the causes of delirium in elderly patients with femoral neck fractures and prevention strategies.

关 键 词：股骨颈骨折 苯二氮䓬 谵妄 

分 类 号：R683.42[医药卫生—骨科学]