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体外循环下心脏手术后认知功能障碍危险因素的研究进展 被引量:7

Research Progress of Risk Factors for Postoperative Cognitive Dysfunction in Patients after Cardiac Surgery Undergoing Cardiopulmonary Bypass
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摘要 术后认知功能障碍(POCD)是体外循环下心脏手术后常见的中枢神经系统并发症,可严重影响患者的预后。目前病因和发病机制尚不清楚,多认为是由患者自身(年龄、术前合并症、受教育程度等)、手术(类型和炎性反应)、体外循环(白细胞激活、肝素使用和温度管理等)及麻醉药物和麻醉深度等多种因素共同作用下导致的神经功能退行性变。该文就近年来体外循环下心脏手术后POCD的相关危险因素进行综述,为早期干预提供依据。 Postoperative cognitive dysfunction(POCD) is the common central nervous system complication in patients after cardiac surgery undergoing cardiopulmonary bypass, which affects the prognosis of the patients. The pathogenesis of POCD remains unclear yet, now is major thought as the neurological hypofunction related to the patient's own situation (age, preoperative complication, education degree ), surgery (type and inflammatory response) , cardiopulmonary bypass( white cell activation, heparin usage and temperature manage- ment etc. ), anesthesia drug and depth. Here is to make a review of the risk factors of POCD in patients after cardiac surgery undergoing cardiooulmonarv bypass, to orovide evidence for early intervention.
作者 涂杰 张炳东
出处 《医学综述》 2014年第6期1047-1050,共4页 Medical Recapitulate
基金 广西壮族自治区卫生厅自筹经费科研课题(Z2012109)
关键词 术后认知功能障碍 体外循环 心脏手术 危险因素 Postoperative cognitive dysfunction Cardiopulmonary bypass Cardiac surgery Risk factors
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参考文献39

  • 1Steinmetz J, Christensen KB, Lund T, et al. Long-term conse- quences of postoperative cognitive dysfunction [ J 1. Anesthesiology, 2009,110 ( 3 ) :548-555.
  • 2Boodhwani M, Rubens F, Wozny D, et al. Effects of sustained mild hypothermia on neurocognitive function after coronary artery bypass surgery : a randomized, double-blind study [ J ]. J Thorac Cardiovasc Surg ,2007,134 ( 6 ) : 1443-1450.
  • 3Nathan H J, Rodriguez R, Wozny D, et al. Neuroprotective effect of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass: five-year follow-up of randomized trial[ J ]. J Thorac Cardiovasc Surg,2007,133 ( 5 ) : 1206-1211.
  • 4陈明盈,毕齐.老年冠心病患者冠状动脉旁路移植术后神经系统并发症[J].中华老年多器官疾病杂志,2012,11(9):682-685. 被引量:12
  • 5Ramaiah R, Lan AM. Postoperative cognitive dysfunction in the elderly[ J]. Anesthesiol Clin ,2009,27 ( 3 ) :485-496.
  • 6Guo H,Tabara Y, Iqase M, et al. Abnormal nocturnal blood pres- sure profile is associated with mild cognitive impairment in the eld- erly :the J-SHIPP study[ J]. Hypertens Res ,2010,33 ( 1 ) :32-36.
  • 7Sendbach S, Lindqnist R, Watanuki S, et al. Correlates of neurocog- nitive function of patients after off-pump coronary artery bypass surgery [ J ]. Am J Crit Care ,2006,15 ( 3 ) :290-298.
  • 8Evered LA, Silbert BS, Scott DA. Postoperative cognitive dysfunc- tion and aortic atheroma [ J ]. Ann Thorac Surg, 2010,89 ( 4 ) : 1091-1097.
  • 9Gallo LC, Malek M J, Gilbertson AD, et al. Perceived cognitive function and emotional distress following coronary artery bypass surgery[ J]. J Behav Med ,2005,28 (5) :433-442.
  • 10Veliz-Reissmtiller G, Agtiero Tortes H, Linden J ,et al. Pre-operative mild cognitive dysfunction predicts risk for post-operative delirium after elective cardiac surgery [ J ]. Aging Clin Exp Res, 2007, 19 (3) :172-177.

二级参考文献24

  • 1Bliss T, CoLlingridge GL. A synaptic model of memory: long-term potentiation in the hippocampus. Nature, 1993, 361 : 31-39.
  • 2Zhang DX, Levy WB. Ketamine blocks the induction of LTP at the lateral entorhinal cortex-dentate gyms synapses. Brain Res, 1992,593 : 124-127.
  • 3Evans MS, Viola-McCabe KE. Midazolam inhibits long-term potentiation through modulation of GABAA receptors.Neuropharmacology, 1996, 35: 347-357.
  • 4Simon W, Hapfehneier G, Kochs E, et al. Isotlurane blocks synaptic plasticity in the mouse hippocampus. Anesthesiology.2001, 94: 1058-1065.
  • 5Barr G, Anderson RE, Owall A, et al. Being awake intermittently during propofol-induced hypnosis: a study of BIS, explicit and implicit memory. Acta Anaesthesiol Scand, 2001,45: 834-838.
  • 6Wei HM, Xiong WY, Yang SC, et al. Propofol facilitates the development of long-term depression (LTD) and impairs the maintenance of long-term potentiation (LTP) in the CAI region of the hippocampus of anesthetized rats. Neuroscience Letters, 2002,324 : 181-184.
  • 7Nagashima K, Zorumski CF, Izumi Y. Propofol Inhibits long-term potentiation but not long-term depression in rat hippocampal slices. Anesthesiology, 2005, 103: 318-326.
  • 8Takamatsu I, Sekiguchi M, Wada K, et al. Propofol-mediated impairment of CAI long-term potentiation in mouse hippocampal slices. Neuroseience Letters, 2005, 389 : 129-132.
  • 9Fujii S, Jia Y, Yang A, et al. Nicotine reverses GABAergic inhibition of long-term potentiation induction in the hippocampal CAI region. Brain Res, 2000, 863: 259-265.
  • 10Kitamura A, Sato R, Marszalee W, et al. Halothane and propofol modulation of gamma-aminobutyric acidA receptor single-channel currents. Anesth Analg, 2004, 99: 409-415.

共引文献38

同被引文献80

  • 1Barletta JF, Miedema SL, Wiseman D, et al. Impact of dexmedetomidine on analgesic requirements in patients af- ter cardiac surgery in a fast track recovery room setting [J]. Pharmacotherapy, 2009,29( 12 ) ~ 1 427.
  • 2Okada H, Kurita T, Mochizuki T, et al. The cardioprotec- tive effect of dexmedetomidine on global ischaemia in iso- lated rat hearts[J]. Resuscitation, 2007,74 (3) :538.
  • 3Boodhwani M,Rubens F,Wozny D,et al.Effects of sustained mild hypothermia on neurocognitive function after coronary artery bypass surgery:a randomized,double-blind study[J].J Thorac Cardiovasc Surg,2007,134(6):1443-1450.
  • 4Motallebzadeh R,Bland JM,Markus HS,et al.Neurocognitive function and cerebral emboli:randomized study of on-pump versus off-pump coronary artery bypass surgery[J].Ann Thorac Surg,2007,83(2):475-482.
  • 5Evered L,Scott DA,Silbert B,et al.Postoperative cognitive dysfunction is independent of type of surgery and anesthetic[J].Anesth Analg,2011,112(5):1179-1185.
  • 6Schoen J,Husemann L,Tiemeyer C,et al.Cognitive function after sevoflurane-vs propofol-based anaesthesia for on-pump cardiac surgery:a randomized controlled trial[J].Br J Anaesth,2011,106(6):840-850.
  • 7Puskas JD,Stringer A,Hwang SN,et al.Neurocognitive and neuroanatomic changes after off-pump versus on-pump coronary artery bypass grafting:long-term follow-up of a randomized trial[J].J Thorac Cardiovasc Surg,2011,141(5):1116-1127.
  • 8Moller CH,Penninga L,Wetterslev J,et al.Off-pump versus on-pump coronary artery bypass grafting for ischaemic heart disease[J].Cochrane Database Syst Rev,2012,14(3):CD007224.
  • 9杨丽芳,熊利泽,路志红,王强,陈敏,汪惠文,李扬.电针预处理对心脏外科手术患者早期认知功能障碍的影响[J].心脏杂志,2009,21(5):712-715. 被引量:5
  • 10郭晓纲,彭东,王晟,罗沙,庄建.磷酸肌酸对心脏瓣膜置换患者围术期心肌保护和血流动力学的影响[J].岭南心血管病杂志,2010,16(6):462-464. 被引量:3

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