心肺转流心脏手术术后谵妄的预防

Prevention of postoperative delirium after cardiac surgery with cardiopulmonary bypass

术后谵妄是手术后常见的神经系统并发症,表现为急性发作的注意力不集中、思维混乱和意识水平的改变等。心肺转流心脏手术患者的术后谵妄发生率明显高于其他类型手术,严重影响患者术后恢复和生存质量。尽管不能完全避免术后谵妄的发生,但有效的预防措施可以明显降低心肺转流心脏手术患者术后谵妄的发生率。本文章回顾近年来国内外术后谵妄的相关研究,简要总结术后谵妄的发生机制,以时间轴为导向,分别以术前、术中、术后三个时段展开,从药物和非药物两方面对心肺转流心脏手术术后谵妄的预防策略进行综述,为临床上更好地预防术后谵妄的发生提供参考。

Postoperative delirium is a common neurological complication in postoperative patients,which is manifested as inattention,confusion of thinking,and change of consciousness level.The incidence of postoperative delirium in patients undergoing cardiac surgery with cardiopulmonary bypass is significantly higher than that in other types of surgery,which seriously affects postoperative recovery and quality of life.Although the occurrence of postoperative delirium cannot be completely avoided,effective preventive measures can significantly reduce the incidence of postoperative delirium in patients undergoing cardiac surgery with cardiopulmonary bypass.In an order of before,during,and after cardiac surgery with cardiopulmonary bypass,this article summarized the relevant researches of drug and non-drug on postoperative delirium at home and abroad in recent years,and reviews the mechanism and prevention strategies of postoperative delirium for better prevention of postoperative delirium in clinical practice.