炎性应激反应与围术期神经认知障碍相关性研究进展

Research Progress on the Correlation between Inflammatory Stress Response and Perioperative Neurocognitive Impairment

围术期神经认知障碍(perioperative neurocognitive disorders,PND)是一种在手术及麻醉后常见的并发症,其临床表现多样,对患者的生活质量和术后恢复均可产生负面影响。炎性应激反应是手术过程中常见的生理反应,在手术创伤后会在中枢神经系统内明显增强,尤其表现在海马区,这一反应会引起长时程的损伤增强效应,从而破坏海马区介导的认知功能,进一步诱发精神紊乱和认知功能障碍,即PND。高龄与潜在的系统疾病都会将原本可自我限制的术后神经炎症反应转变为一种持续不断的反应状态,加剧认知功能损伤。本文对近年深入探讨炎性应激反应与手术患者PND的相关文献进行综述,以找到更加有效的预防和治疗策略,为围术期患者的认知功能保护提供有力支持。

Perioperative neurocognitive disorder(PND)is one of the most common complications after surgery and anesthesia.Its clinical manifestations are varied,which can adversely affect patients'quality of life and postoperative recovery.Inflammatory stress response is a common physiological response during surgery,which will be significantly enhanced in the central nervous system after surgical trauma,especially in the hippocampus.This response will cause long-term damage enhancement effect,thus damaging the cognitive function mediated by the hippocampus and further inducing mental disorders and cognitive dysfunction,namely PND.Advanced age and underlying systemic disease can transform a self-limiting postoperative neuroinflammatory response into a state of continuous response that exacerbates cognitive impairment.This article reviews the relevant literature on the in-depth exploration of inflammatory stress response and PND in surgical patients,so as to find more effective prevention and treatment strategies,and provide strong support for the protection of cognitive function in perioperative patients.