Postoperative Cognitive Dysfunction
Postoperative Cognitive Dysfunction
复制标题
DOI：
10.1007/s40140-017-0238-1
复制
发表时间：
2017-10
影响因子：
1.3
通讯作者：
Valerie J. Page;Fiona C. Oglesby;Richard A. Armstrong
中科院分区：
文献类型：
--
作者：
Valerie J. Page;Fiona C. Oglesby;Richard A. Armstrong
综述目的：术后认知功能障碍（POCD）是一种定义不明确的综合征，用于描述麻醉和手术后患者的认知功能障碍。这种叙述性POCD审查概述了相关文献的动物和临床研究发表在过去5年内，重点是老年patients.Recent findingsIncreasing年龄是一个公认的危险因素POCD，在某些患者中，由此产生的认知功能障碍将持续存在。与术后谵妄的关系尚不清楚。有证据表明，手术应激导致的神经炎症是POCD的一个关键因素，预先存在认知障碍的患者尤其危险。临床研究包括相互矛盾的结果，关于麻醉技术和小的假设生成单网站的研究生物标志物和潜在的therapeutis.SummaryA的定义和诊断标准POCD是迫切需要通知研究的病理生理学，识别患者的风险和麻醉管理，旨在改善患者的预后。最后，我们对当前的临床实践提出了建议。
Purpose of reviewPostoperative cognitive dysfunction (POCD) is a poorly defined syndrome to describe cognitive impairment in patients following anaesthesia and surgery. This narrative POCD review outlines the relevant literature from animal and clinical studies published within the last 5 years with a focus on elderly patients.Recent findingsIncreasing age is a well-recognised risk factor for POCD, and in some patients, the resulting cognitive impairment will persist. The association with postoperative delirium is unclear. The evidence supports that neuroinflammation as a result of surgical stress is a key factor in POCD, and patients with pre-existing cognitive impairment are particularly at risk. Clinical research consists of conflicting results with regard to the anaesthetic technique and small hypothesis-generating single-site studies regarding biomarkers and potential therapies.SummaryA definition and diagnostic criteria for POCD are urgently needed to inform research into the pathophysiology, identification of patients at risk and anaesthetic management designed to improve patient outcomes. We conclude with a recommendation for current clinical practice.