术后认知功能障碍的评判方法与评判标准

The methods and criterions for evaluating postoperative cognitive dysfunction

背景术后认知功能障碍（postoperative cognitive dysfunction，POCD）作为麻醉手术后中枢神经系统的并发症越来越受到重视，由于没有POCD的统一研究方法、严密的定义和诊断标准，POCD的研究结果大相径庭。目的本文回顾了近年来国内外POCD研究中常用评判指标与评判标准，为统一POCD的诊断参数、正确识别POCD提供参考。内容神经心理学方法是目前POCD临床研究中最常使用的方法。但是，神经心理测验最终能否反映认知功能的真实变化还依赖于研究中所选用的神经心理测验的敏感性、重测信度、有无设立对照组、重测的间隔时间以及评判标准等等。趋向尽管国内外已有大量POCD研究报道，但对于最终的防治工作来说，统一POCD的诊断标准具有不可或缺的重要作用。

Background Postoperative cognitive dysfunction （POCD）, as a post operative complication of the central nervous system, begins to get more attention. However, without clear definition, uniform evaluating methods and diagnosis criterion, the conclusions from POCD studies are quite different from each other. Objective This article reviews the evaluating measurement techniques and diagnosis criterion in detecting postoperative cognitive function from departed POCD studies both at home and abroad. It provides reference for establishing consensus of diagnosis parameters for POCD and helps to better evaluate POCD. Content The neuropsychological assessments is the most commonly used method in clinical studies of POCD. However, whether any changes of cognitive function could be reflected correctly and precisely from neuropsychological method depends on the sensitiveness of neuropsychological tests chosen, test-retest reliability, control group, the time between pre-and post-operative measurements, assessment criterion, etc. Trend Even though POCD have been learned in many studies for many years, a clear and consistent evaluating criterion is still absolutely necessary for POCD prevention and treatment .