围术期神经认知障碍危险因素与防治的研究进展

Research progress on risk factors and prevention of perioperative neurocognitive disorders

围术期神经认知障碍是一种麻醉和手术后常见并发症,临床表现细微多样,取决于被影响的特定认知区域,最常见的临床表现是记忆受损、信息处理能力下降、智力减退和焦虑。其危险因素众多,患者的自身(年龄、文化程度、术前合并症等)、术中情况(手术类型、麻醉方法、麻醉深度、麻醉时间等)及术后情况(术后疼痛与术后炎性反应)均为相关危险因素。此并发症不仅增加经济负担,降低生活质量,而且严重影响患者术后恢复,给个人、家庭、社会带来巨大负担,至今仍未有明确的诊断方法和治疗手段。近年来,围术期神经认知障碍的危险因素及预防倍受关注,研究成果为临床研究、预测、预防、治疗提供新的思路。该文就近年来围术期神经认知障碍相关危险因素进行综述,为早期干预提供依据。

The perioperative neurocognitive disorder is a common complication after anesthesia and surgery,and its clinical manifestations are refined and diversified,which depend on the specific cognitive area affected.The most common clinical manifestations are memory impairment,decreased information processing ability,mental decrease and anxiety.There are many related risk factors,which include the patient’s conditions(age,education level and comorbidities),intraoperative conditions(type of operation,anesthesia method,depth of anesthesia and anesthesia time),and postoperative conditions(pain and inflammation).This complication not only increases the economic burden and reduces the life quality of patients,but also seriously affects the recovery of patients after surgery,which brings a huge burden to individuals,families and society.There is no clear diagnosis method and treatment method up to now.In recent years,the risk factors and prevention of perioperative neurocognitive disorders have been paid much attention to,and research results have provided new ideas for clinical research,prediction,prevention,and treatment.This article reviews the risk factors about perioperative neurocognitive disorders in recent years,so as to provide a basis for early intervention of the disease.