麻醉药物应用与患者术后认知功能障碍的研究进展

doi:10.3969/j.issn.2095-1396.2018.03.004

摘要/Abstract

摘要：

认知是大脑获取、记忆和处理信息的过程，术后认知功能障碍（postoperative cognitive dysfunction， POCD）是麻醉手术后患者出现的认知功能障碍，是手术麻醉后一种常见的并发症。POCD 患者临床表现个体差异较大，主要表为短期记忆和执行功能受损，尤其是短期记忆受损。近年来，POCD 越来越受到临床医生的重
视，尤其是幼年及老年患者经历大手术后POCD 发生率极高。POCD 影响患者术后的恢复，早期POCD 可能会演变成长期的认知功能障碍，将严重影响患者的生活质量，并对家庭及社会造成严重经济负担。尽管麻醉药物不断更新，其性能不断优化，且麻醉手术中相关监测技术也日益提高，但临床POCD 的发生率仍然较高。迄今为止，仍未见行之有效的预防POCD 的方法。该文就各种主要麻醉药物对患者POCD 的影响及机制进行综述，旨在为临床麻醉方案实施及POCD 防治提供参考及新的思路。

关键词: 认知, 麻醉, 术后认知功能障碍, 机制, 思路

Abstract:

Cognition is the process by which the brain acquires，remembers and processes information. Postoperative cognitive dysfunction （POCD） is a kind of cognitive dysfunction in patients after anesthesia operation and is a common complication after surgery. The clinical manifestations of patients with POCD vary widely，mainly due to impaired short-term memory and executive function，especially short-term memory impairment. In recent years，POCD has been paid more and more attention，and the incidence of POCD among young and old patients，especially those have experienced large surgery，is extremely high. POCD affects postoperative recovery of patients，and early POCD may develop into long-term cognitive impairment，which will seriously affect the quality of life and cause severe economic burden to families and society.Although anesthetic drugs are constantly updated，their performance is constantly optimized，and related monitoring techniques are increasingly improved in anesthetic surgery，the incidence of POCD is still high. So far，there is still no effective method to prevent POCD. This paper summarized the effects and mechanisms of various anesthetic drugs on POCD，and aimed to provide references and new ideas for the implementation of clinical anesthesia programs and the prevention and treatment of POCD.

Key words: cognition, anesthesia, POCD, mechanism, ideas

中图分类号:

R964

朱敏1,李凌海2. 麻醉药物应用与患者术后认知功能障碍的研究进展[J]. 神经药理学报, DOI: 10.3969/j.issn.2095-1396.2018.03.004.

ZHU Min1, LI Ling-hai2. Advances in Research on Application of Anesthetics and Postoperative Cognitive Dysfunction in Patients[J]. Acta Neuropharmacologica, DOI: 10.3969/j.issn.2095-1396.2018.03.004.

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