麻醉相关因素与术后神经认知障碍之间的关联:一个后期分析
Manon Stern1, Gertrude J Nieuwenhuijs-Moeke1, Anthony Absalom1
1Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
BMC anesthesiology
|November 10, 2023
概括
手术后神经认知障碍 (pNCD) 在3个月后不常见,更长的麻醉持续时间是关键风险因素. 手术后认知功能通常会得到改善,但对高危患者来说,仔细监测是必不可少的.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 老年医学 老年医学
背景情况:
- 手术后的神经认知障碍 (pNCD) 是手术后的一个重大问题.
- 虽然研究了早期的PNCD,但3个月内持续认知障碍的风险因素仍然不太了解.
- 麻醉剂和程序是pNCD的潜在贡献者.
研究的目的:
- 在手术后3个月确定与PNCD相关的麻醉相关风险因素.
- 研究麻醉管理与长期认知结果之间的关系.
主要方法:
- 对65岁或以上的患者进行前性观察性研究,这些患者正在接受固体瘤切除.
- 在手术前和3个月后使用5个神经心理测试评估认知功能.
- pNCD定义为≥2次测试≥25%的下降;用于分析麻醉相关因素的后勤回归.
主要成果:
- 在196名患者中,12%的患者在3个月后发展为PNCD.
- 低的手术前迷你精神状态检查得分和更长的麻醉时间是pNCD的重要风险因素.
- 平均而言,患者在术后的认知测试得分有所改善.
结论:
- 麻醉时间,反映了手术复杂性,是3个月后PNCD的唯一麻醉相关预测因素.
- 在这个队列中,经手术后认知功能总体上有所改善.
- 进一步的研究可能会阐明导致持续性PNCD的特定麻醉或手术因素.
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