脊柱手术后认知功能障碍和术后谵妄  

Cognitive dysfunction and postoperative delirium after spinal surgery

作　　者：刘东 陶庆宇 朱海娟[2] 余骏马[1] LIU Dong;TAO Qingyu;ZHU Haijuan;YU Junma(Department of Anesthesiology,Third Affiliated Hospital of Anhui Medical University,First People’s Hospital of Hefei,Hefei 230061;Department of Anesthesiology,Maternal and Child Health Hospital Affiliated to Anhui Medical University,Hefei 230001,China)

机构地区：[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

出　　处：《临床与病理杂志》2024年第2期313-319,共7页Journal of Clinical and Pathological Research

基　　金：安徽省卫生健康委员会科研项目(2022-145)。

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。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 

分 类 号：R614[医药卫生—麻醉学]