精神活性药物的历史是心脏手术后神经认知衰退的危险因素
Madigan E Stanley1, Afshin Ehsan1, Neel R Sodha1
1Divison of Cardiothoracic Surgery, Warren Alpert Medical School at Brown University and Rhode Island Hospital, Providence, Rhode Island.
The Journal of surgical research
|December 9, 2023
概括
接受心脏手术的患者面临神经认知衰退 (NCD) 的高风险. 手术前使用精神活性药物显著增加了这种风险,突出了外科手术团队需要考虑的关键因素.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 神经认知衰退 (NCD) 是心脏手术后的常见并发症,影响患者的结果和生活质量.
- 确定非传染性疾病的风险因素对于制定预防策略和改善患者咨询至关重要.
研究的目的:
- 调查术前药物使用与心脏手术后急性神经认知衰退的发生率之间的关联.
- 确定可能增加术后NCD风险的特定药物类别.
主要方法:
- 一项前性队列研究,涉及104名接受心脏手术的患者.
- 在手术前和手术后的第4天和第30天,使用可重复的神经心理状态评估电池 (RBANS) 评估神经认知功能.
- 审查了患者的药物历史,包括精神活性药物和术后阿片类药物使用.
主要成果:
- 在42.9%的患者中检测到神经认知衰退 (NCD).
- 在手术前服用精神活性药物 (56.8%) 的患者中,与不服用这些药物 (31.9%) 的患者相比,观察到NCD的发病率显著更高.
- 没有发现NCD与使用β-阻断剂,ACE抑制剂/ARB,通道阻断剂,他类药物或口服低血糖剂之间的显著关联.
结论:
- 精神活性药物使用史是心脏手术后急性神经认知衰退的重要危险因素.
- 这一发现表明,手术前使用精神活性药物需要在进行心脏手术的患者的风险评估和管理中仔细考虑.
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