[1]孟 强,孙 杨,刘 永.术后谵妄病理生理机制的研究现状[J].医学信息,2018,31(19):54-56.[doi:10.3969/j.issn.1006-1959.2018.19.018]
 MENG Qiang,SUN Yang,LIU Yong.Current Status of Research on Pathophysiological Mechanism of Postoperative Delirium[J].Medical Information,2018,31(19):54-56.[doi:10.3969/j.issn.1006-1959.2018.19.018]
点击复制

术后谵妄病理生理机制的研究现状()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年19期
页码:
54-56
栏目:
综述
出版日期:
2018-10-01

文章信息/Info

Title:
Current Status of Research on Pathophysiological Mechanism of Postoperative Delirium
文章编号:
1006-1959(2018)19-0054-03
作者:
孟 强1孙 杨2刘 永1
1.空军军医大学附属唐都医院神经外科,陕西 西安 710038; 2.厦门大学附属翔安医院神经外科,福建 厦门 361100
Author(s):
MENG Qiang1SUN Yang2LIU Yong1
1.Department of Neurosurgery,Tangdu Hospital,Air Force Military Medical University,Xi’an 710038,Shaanxi,China; 2.Department of Neurosurgery,Xiang’an Hospital,Xiamen University,Xiamen 361100,Fujian ,China
关键词:
术后谵妄缺血性脑损伤神经递质失调神经炎症
Keywords:
Postoperative deliriumIschemic brain injuryNeurotransmitter dysregulation Neuroinflammation
分类号:
R749.1+6
DOI:
10.3969/j.issn.1006-1959.2018.19.018
文献标志码:
A
摘要:
术后谵妄是各类外科术后常见的一种严重并发症。然而,关于术后谵妄的病理生理机制尚未清楚。多种机制共同参与了术后谵妄的发生发展。目前,可能涉及的机制包括缺血性脑损伤、神经递质失调和神经炎症。理解其病理生理机制有助于积极预防和治疗该并发症。本文对术后谵妄的最新机制研究进行综述,以期为临床实践和研究提供必要的参考依据。关键词:术后谵妄;缺血性脑损伤;神经递质失调;神经炎症
Abstract:
Postoperative delirium is a common serious complication after various types of surgery. However,the pathophysiological mechanisms of postoperative delirium are not known.A variety of mechanisms have been involved in the development of postoperative delirium.Currently,mechanisms that may be involved include ischemic brain damage,neurotransmitter disorders,and neuroinflammation.Understanding its pathophysiological mechanisms helps to actively prevent and treat this complication.This article reviews the latest mechanisms of postoperative delirium in order to provide the necessary reference for clinical practice and research.

参考文献/References:

[1]Inouye SK,Westendorp RG,Saczynski JS.Delirium in elderly people[J].Lancet,2013,383(9920):911-922. [2]Bettelli G,Neuner B.Postoperative delirium:a preventable complication in the elderly surgical patient[J].Monaldi Arch Chest Dis,2017,87(2):842-845. [3]Florou C,Theofilopoulos D,Tziaferi S,et al.Post-operative delirium in elderly people diagnostic and management issues of post-operative delirium in elderly people[J].Adv Exp Med Biol,2017(987):301-312. [4]Brown C,Faigle R,Klinker L,et al.The Association of Brain MRI Characteristics and Postoperative Delirium in Cardiac Surgery Patients[J].Clinical Therapeutics,2015,37(12):2686-2699. [5]Hshieh TT,Fong TG,Marcantonio ER,et al.Cholinergic deficiency hypothesis in delirium:a synthesis of current evidence[J].J Gerontol A Biol Sci Med Sci,2008,63(7):764-772. [6]Noble F,Rubira E,Boulanouar M,et al.Acute systemic inflam mation induces central mitochondrial damage and amnesic deficit in adult Swiss mice[J].Neurosci Lett,2007,424(2):106-110. [7]American Psychiatric Association,DSM-5 Task Force.Diagnostic and statistical manual of mental disorders:DSM-5[M].5th edition.Washington,DC:American Psychiatric Association,2013:586-592. [8]Han JH,Wilson A,Vasilevskis EE,et al.Diagnosing delirium in older emergency department patients:validity and reliability of the delirium triage screen and the brief confusion assessment method[J].Ann Emerg Med,2013,62(5):457-465. [9]Wei LA,Fearing MA,Sternberg EJ,et al.The confusion assessment method:a systematic review of current usage[J].J Am Geriatr Soc,2008,56(5):823-830. [10]Coxa G,Tzioupis C,Calori GM,et al.Cerebral fat emboli:A trigger of post-operative delirium[J].Injury,2011,42(S4):S6-S10. [11]Koch S,Forteza A,Lavernia C,et al.Cerebral fat microembolism and cognitive decline after hip and knee replacement[J].Stroke,2007,38(3):1079-1081. [12]Hirsch J,DePalma G,Tsai TT,et al.Impact of intraoperative hypotension and blood pressure fluctuations on early postoperativedelirium after non-cardiac surgery[J].Br J Anaesth,2015,115(3):418-426. [13]Al TL,Van dVM,Meyns B,et al.Serum protein S100 as marker of postoperative delirium after off-pump coronary artery bypass surgery: secondary analysis of two prospective randomized controlled trials[J].Clinical Chemistry & Laboratory Medicine,2016,54(10):1671. [14]Bayram H,Hidiroglu M,Cetin L,et al.Comparing S-100 beta protein levels and neurocognitive functions between patients undergoing on-pump and off-pump coronary artery bypass grafting [J]. J Surg Res,2013,182(2):198-202. [15]Omiya H,Yoshitani K,Yamada N,et al.Preoperative brain magnetic resonance imaging and postoperative delirium after off-pump coronary artery bypass grafting:a prospective cohort study [J].Can J Anaesth,2015,62(6):595-602. [16]Yilmaz S,Aksoy E,Diken AI,et al.Dopamine administration is a risk factor for delirium in patients undergoing coronary artery bypass surgery[J].Heart Lung Circ,2016,25(5):493-498. [17]Dawson AH,Buckley NA.Pharmacological management of anticholinergic delirium-theory,evidenceandpractice[J].Br J Clin Pharmacol,2016,81(3):516-524. [18]Tampi RR,Tampi DJ,Ghori AK.Acetylcholinesterase inhibitors for delirium in older adults [J]. Am J Alzheimers Dis Other Demen,2016,31(4):305-310. [19]Yilmaz S,Aksoy E,Diken AI,et al.Dopamine administration is a risk factor for delirium in patients undergoing coronary artery bypass surgery[J].Heart Lung Circ,2016,25(5):493-498. [20]Egberts A,Fekkes D,Wijnbeld EHA,et al.Disturbed Serotonergic Neurotransmission and Oxidative Stress in Elderly Patients with Delirium[J].Dement Geriatr Cogn Disord Extra,2015,5(3):450-458. [21]Volpi-Abadie J,Kaye AM,Kaye AD.Serotonin Syndrome[J].Ochsner J,2013,13(4):533-540. [22]Cerejeira J,Nogueira V,Luís P,et al.The cholinergic system and inflammation:common pathways in delirium pathophysiology[J].J Am Geriatr Soc,2012,60(4):669-675. [23]Cerejeira J,Firmino H,Vaz-Serra A,et al.The neuroinflammatory hypothesis of delirium [J]. Acta Neuropathol,2010,119(6):737-754. [24]Facci L,Barbierato M,Marinelli C,et al.Toll-Like Receptors 2,-3 and -4 Prime Microglia but not Astrocytes Across Central Nervous System Regions for ATP-Dependent Interleukin-1β Release [J].Sci Rep,2014,4(10):6824-6833. [25]Fu HQ,Yang T,Xiao W,et al.Prolonged Neuroinflammation after Lipopolysaccharide Exposure in Aged Rats[J].Plos one,2014,9(8):e106331-e106340. [26]van Munster BC,Korevaar JC,Zwinderman AH,et al.Time-course of cytokines during delirium in elderly patients with hip fractures[J].Journal of the American Geriatrics Society,2010,56(9):1704-1709. [27]Su X,Meng ZT,Wu XH,et al.Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery:a randomised,double-blind,placebo-controlled trial[J]. Lancet,2016,388(10054):1893-1902.

相似文献/References:

[1]国欣涛,魏荣伟,王 斌.冠状动脉搭桥术后谵妄的研究现状[J].医学信息,2019,32(10):53.[doi:10.3969/j.issn.1006-1959.2019.10.019]
 GUO Xin-tao,WEI Rong-wei,WANG Bin.Current Status of Research on Postoperative Delirium Coronary Artery Bypass Grafting[J].Medical Information,2019,32(19):53.[doi:10.3969/j.issn.1006-1959.2019.10.019]
[2]张思捷.右美托咪定对老年患者腹腔镜宫颈癌根治术后谵妄的预防效果观察[J].医学信息,2022,35(15):87.[doi:10.3969/j.issn.1006-1959.2022.15.019]
 ZHANG Si-jie.Observation on the Preventive Effect of Dexmedetomidine on Postoperative Delirium in Elderly Patients After Laparoscopic Radical Hysterectomy for Cervical Cancer[J].Medical Information,2022,35(19):87.[doi:10.3969/j.issn.1006-1959.2022.15.019]
[3]张晓伟,张 敏,项明琼,等.小剂量右美托咪定对老年患者膝关节置换术后谵妄的防治效果[J].医学信息,2020,33(15):148.[doi:10.3969/j.issn.1006-1959.2020.15.047]
 ZHANG Xiao-wei,ZHANG Min,XIANG Ming-qiong,et al.The Effect of Low-dose Dexmedetomidine on the Prevention and Treatmentof Delirium After Knee Replacement in Elderly Patients[J].Medical Information,2020,33(19):148.[doi:10.3969/j.issn.1006-1959.2020.15.047]
[4]陈 静,付文广,刘 莉,等.老年开腹手术患者术后谵妄影响因素研究[J].医学信息,2020,33(16):68.[doi:10.3969/j.issn.1006-1959.2020.16.021]
 CHEN Jing,FU Wen-Guang,LIU Li,et al.Study on Influencing Factors of Postoperative Delirium in Elderly Patients Undergoing Open Surgery[J].Medical Information,2020,33(19):68.[doi:10.3969/j.issn.1006-1959.2020.16.021]
[5]唐 莉,王 强,颜 飞.围手术期谵妄发病机制及药物预防的研究[J].医学信息,2020,33(22):51.[doi:10.3969/j.issn.1006-1959.2020.22.016]
 TANG Li,WANG Qiang,YAN Fei.Study on the Pathogenesis and Drug Prevention of Delirium During Perioperative Period[J].Medical Information,2020,33(19):51.[doi:10.3969/j.issn.1006-1959.2020.22.016]
[6]黄伟华,张 杰,丁声双,等.椎管内麻醉与全身麻醉对髋部骨折患者术后谵妄影响的Meta分析[J].医学信息,2022,35(23):50.[doi:10.3969/j.issn.1006-1959.2022.23.008]
 HUANG Wei-hua,ZHANG Jie,DING Sheng-shuang,et al.Meta-analysis of the Effects of Spinal Anesthesia and General Anesthesia on Postoperative Delirium in Patients with Hip Fracture[J].Medical Information,2022,35(19):50.[doi:10.3969/j.issn.1006-1959.2022.23.008]
[7]尚子祥,李 锐.老年胃肠道手术患者术后谵妄的危险因素分析[J].医学信息,2021,34(05):107.[doi:10.3969/j.issn.1006-1959.2021.05.030]
 SHANG Zi-xiang,LI Rui.Analysis of Risk Factors for Postoperative Delirium in Elderly Patients Undergoing Gastrointestinal Surgery[J].Medical Information,2021,34(19):107.[doi:10.3969/j.issn.1006-1959.2021.05.030]
[8]王 婧,王 昊.在Narcotrend监测下观察胸椎旁神经阻滞对于胸腔镜手术术后谵妄的影响[J].医学信息,2021,34(20):74.[doi:10.3969/j.issn.1006-1959.2021.20.018]
 WANG Jing,WANG Hao.Effect of Thoracic Paravertebral Nerve Block on Postoperative Delirium AfterThoracoscopic Surgery Under Narcotrend Monitoring[J].Medical Information,2021,34(19):74.[doi:10.3969/j.issn.1006-1959.2021.20.018]
[9]曹亚红,李 锐.腹横肌平面阻滞对老年胃肠肿瘤患者术后神经认知功能的影响[J].医学信息,2022,35(08):93.[doi:10.3969/j.issn.1006-1959.2022.08.022]
 CAO Ya-hong,LI Rui.Effect of Transverse Abdominal Muscle Plane Block on Postoperative Neurocognitive Function in Elderly Patients with Gastrointestinal Tumors[J].Medical Information,2022,35(19):93.[doi:10.3969/j.issn.1006-1959.2022.08.022]
[10]程李夏,马贵芬,夏晓琼.亚麻醉剂量艾司氯胺酮联合TAPB对老年腹部手术患者神经认知功能的影响[J].医学信息,2024,37(04):83.[doi:10.3969/j.issn.1006-1959.2024.04.015]
 CHENG Li-xia,MA Gui-fen,XIA Xiao-qiong.Effect of Subanesthetic Dose of Esketamine Combined with TAPB on Neurocognitive Function in Elderly Patients Undergoing Abdominal Surgery[J].Medical Information,2024,37(19):83.[doi:10.3969/j.issn.1006-1959.2024.04.015]

更新日期/Last Update: 2018-10-29