术后疲劳综合征(Postoperative fatigue syndrome, POFS)是外科术后常见并发症,是指患者在手术后主观感觉处于一段疲劳期,表现为机体持续的疲惫、乏力、睡眠紊乱、专注力下降等,广泛存在于各种手术之后,尤其是腹部、妇科、心脏和小手术...术后疲劳综合征(Postoperative fatigue syndrome, POFS)是外科术后常见并发症,是指患者在手术后主观感觉处于一段疲劳期,表现为机体持续的疲惫、乏力、睡眠紊乱、专注力下降等,广泛存在于各种手术之后,尤其是腹部、妇科、心脏和小手术。术后疲劳综合征不仅仅是生理疲劳,还包括心理疲劳和认知疲劳,其严重程度和持续时间可能会对患者的术后恢复产生深远影响。静脉麻醉药在手术中常被使用,探讨其对术后疲劳综合征的影响具有重要临床意义。Postoperative fatigue syndrome (POFS) is a common postoperative complication in surgery, which refers to the subjective feeling of fatigue in patients after surgery, manifested as continuous fatigue, weakness, sleep disorders, decreased concentration, etc. It is widely present after various surgeries, especially in the abdomen, gynecology, heart, and minor surgeries. Postoperative fatigue syndrome is not only physiological fatigue, but also includes psychological fatigue and cognitive fatigue, and its severity and duration may have a profound impact on patients’ postoperative recovery. Intravenous anesthetics are often used during surgery, and exploring their effects on postoperative fatigue syndrome is of great clinical significance.展开更多
目的应用静息态功能磁共振(rest state functional magnetic resonance imaging,rs-fMRI)成像技术观察深度麻醉下静脉麻醉药丙泊酚对大脑功能连结性的影响。方法 6位在术中磁共振手术室行经蝶垂体瘤切除术的神经外科患者,采用丙泊酚靶...目的应用静息态功能磁共振(rest state functional magnetic resonance imaging,rs-fMRI)成像技术观察深度麻醉下静脉麻醉药丙泊酚对大脑功能连结性的影响。方法 6位在术中磁共振手术室行经蝶垂体瘤切除术的神经外科患者,采用丙泊酚靶控输注(效应室浓度4μg/mL)进行麻醉诱导并维持。分别在患者处于清醒、麻醉和麻醉下进行疼痛刺激三种状态时应用3.0T场强磁共振仪进行扫描。获取的影象学资料应用AFNI软件分析大脑默认网络,体感运动网络和疼痛相关网络的功能连结性,并用SPSS统计软件进行统计分析。结果种子体素相关分析法结果显示,与清醒状态相比,丙泊酚导致在外科麻醉水平大脑默认网络、躯体运动感觉皮层以及疼痛相关脑区岛叶皮层的脑功能连接显著下降,表现为扣带回、内侧前额叶、岛叶等脑区被抑制(P<0.01)。疼痛刺激后在躯体运动感觉皮层及疼痛相关脑区的功能连接呈现部分恢复,表现为右侧舌回、梭状回、岛叶及扣带回区出现不同程度的激活(P<0.01);而默认网络的功能连接则进一步下降(P<0.01)。结论在外科麻醉水平,丙泊酚导致大脑各脑区功能连接减弱,提示可能与意识水平降低相关。扣带回、岛叶以及内侧前额叶可能是丙泊酚中枢作用靶点。而疼痛刺激虽可恢复部分脑区功能连结性,但重要脑区的功能连结性仍显著下降。展开更多
文摘术后疲劳综合征(Postoperative fatigue syndrome, POFS)是外科术后常见并发症,是指患者在手术后主观感觉处于一段疲劳期,表现为机体持续的疲惫、乏力、睡眠紊乱、专注力下降等,广泛存在于各种手术之后,尤其是腹部、妇科、心脏和小手术。术后疲劳综合征不仅仅是生理疲劳,还包括心理疲劳和认知疲劳,其严重程度和持续时间可能会对患者的术后恢复产生深远影响。静脉麻醉药在手术中常被使用,探讨其对术后疲劳综合征的影响具有重要临床意义。Postoperative fatigue syndrome (POFS) is a common postoperative complication in surgery, which refers to the subjective feeling of fatigue in patients after surgery, manifested as continuous fatigue, weakness, sleep disorders, decreased concentration, etc. It is widely present after various surgeries, especially in the abdomen, gynecology, heart, and minor surgeries. Postoperative fatigue syndrome is not only physiological fatigue, but also includes psychological fatigue and cognitive fatigue, and its severity and duration may have a profound impact on patients’ postoperative recovery. Intravenous anesthetics are often used during surgery, and exploring their effects on postoperative fatigue syndrome is of great clinical significance.
文摘目的应用静息态功能磁共振(rest state functional magnetic resonance imaging,rs-fMRI)成像技术观察深度麻醉下静脉麻醉药丙泊酚对大脑功能连结性的影响。方法 6位在术中磁共振手术室行经蝶垂体瘤切除术的神经外科患者,采用丙泊酚靶控输注(效应室浓度4μg/mL)进行麻醉诱导并维持。分别在患者处于清醒、麻醉和麻醉下进行疼痛刺激三种状态时应用3.0T场强磁共振仪进行扫描。获取的影象学资料应用AFNI软件分析大脑默认网络,体感运动网络和疼痛相关网络的功能连结性,并用SPSS统计软件进行统计分析。结果种子体素相关分析法结果显示,与清醒状态相比,丙泊酚导致在外科麻醉水平大脑默认网络、躯体运动感觉皮层以及疼痛相关脑区岛叶皮层的脑功能连接显著下降,表现为扣带回、内侧前额叶、岛叶等脑区被抑制(P<0.01)。疼痛刺激后在躯体运动感觉皮层及疼痛相关脑区的功能连接呈现部分恢复,表现为右侧舌回、梭状回、岛叶及扣带回区出现不同程度的激活(P<0.01);而默认网络的功能连接则进一步下降(P<0.01)。结论在外科麻醉水平,丙泊酚导致大脑各脑区功能连接减弱,提示可能与意识水平降低相关。扣带回、岛叶以及内侧前额叶可能是丙泊酚中枢作用靶点。而疼痛刺激虽可恢复部分脑区功能连结性,但重要脑区的功能连结性仍显著下降。
