术后疼痛引起老年患者术后认知功能障碍的相关机制研究进展

Research progress of the role of postoperative pain in the development of postoperative cognitive dysfunction in geriatric patients

术后认知功能障碍(POCD)与年龄、手术创伤、炎症、疼痛、麻醉等多因素作用有关,而手术创伤导致的术后疼痛可能起着重要作用。本文就术后疼痛在POCD发病中的相关机制,如神经损伤、神经重塑、应激创伤等以及如何加强老年患者POCD的预防与治疗等方面对其研究进展作一综述。总结近年来的研究进展及热点,通过评估患者的术后疼痛状态,制订合理的多模式镇痛,从而有效预防、干预POCD的发生发展,对于加强老年患者围术期脑功能的保护至关重要。

Previous studies have shown that postoperative cognitive dysfunction (POCD) is related to multiple factors including age,postoperative trauma,inflammation,postoperative pain,and anesthesia,among which postoperative pain is thought to play an important role in the development of POCD.This review summarizes the recent findings in the study of the role of postoperative pain in the pathogenesis of POCD in light of nerve injuries,neural remodeling and stress,and the progress in the prevention and treatment of POCD in elderly patients.It is of vital important to assess the postoperative pain and formulate adequate analgesic regimens for effective prevention and management of POCD to protect the brain functions of elderly patients.