老年衰弱患者术后谵妄研究进展

Progress in the Study of Postoperative Delirium in Elderly Patients with Frailty

衰弱综合征在老年患者中较常见,严重威胁老年患者身心健康及生存质量。目前,衰弱已然成为谵妄发生的高危因素。由于手术影响,部分老年衰弱患者术后极有可能出现谵妄,导致术后并发症增加、住院时间延长、死亡率上升。但因衰弱与谵妄的发病机制存在复杂性和多因素性,目前缺乏特异性治疗手段。本文综述了术后谵妄的危险因素,衰弱和术后谵妄之间的相关性以及二者的病理生理机制,并总结预防术后谵妄的干预方案,为保证老年衰弱患者的围术期的安全性提供参考。

Frailty syndrome is more common in elderly patients, which seriously threatens their physical and mental health and quality of survival. At present, frailty has definitely become a high-risk factor for the occurrence of delirium. Due to the influence of surgery, some elderly frail patients are extreme-ly likely to develop delirium after surgery, resulting in increased postoperative complications, pro-longed hospitalization, and increased mortality. However, because of the complexity and multifac-torial nature of the pathogenesis of frailty and delirium, there is a lack of specific treatment. This article reviews the risk factors for postoperative delirium, the correlation between frailty and postoperative delirium as well as the pathophysiological mechanisms of both, and summarizes the intervention protocols for the prevention of postoperative delirium, which provides a reference to ensure the perioperative safety of elderly patients with frailty.