STRESS RESPONSE TO SURGERY AND POSSIBLE WAYS OF ITS CORRECTION
STRESS RESPONSE TO SURGERY AND POSSIBLE WAYS OF ITS CORRECTION
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DOI：
10.2478/v10046-012-0014-z
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发表时间：
2012-01-01
期刊：
影响因子：
--
通讯作者：
Boka, Viesturs
中科院分区：
文献类型：
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作者：
Ivanovs, Igors;Mihelsons, Maris;Boka, Viesturs
手术的应激反应对机体有两种主要的系统影响：神经内分泌和血液免疫。神经内分泌效应是由下丘脑-垂体-肾上腺轴和交感-肾上腺-髓质轴的变化引起的。血液免疫效应的特点是细胞因子的产生、急性期反应和淋巴细胞和中性粒细胞的增殖。所有这些反应都紧密地相互作用。应激反应的延长可增加发病率并使术后预后恶化。手术应激可受术前、围手术期和术后因素的影响。在本文中，我们回顾了与压力相关的主要神经内分泌和血液免疫变化，并讨论了减少手术应激反应的不同可能方法。
The stress response to surgery has two main systemic effects in an organism: neuroendocrine and haemato-immunological. Neuroendocrine effects are induced by changes in the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary axis. Haemato-immunological effects are characterised by cytokine production, acute phase reaction and lymphocyte and neutrophil proliferation. All of these responses interact closely. Prolongation of the stress response can increase morbidity and worsen postoperative outcome. Surgical stress can be affected by preoperative, perioperative and postoperative factors. In this paper, we review the main neuroendocrine and haemato-immunological changes related to stress and discuss different possible approaches to minimise the stress response to surgery.