外科手术期间自主神经系统失衡对外科手术结果的影响:一个系统性审查
Wei-Tong Pan1, Mu-Huo Ji2, Daqing Ma3
1Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China; Neuroscience Research Institute, Zhengzhou University Academy of Medical Sciences, Zhengzhou, Henan, China.
外科手术期间的自主神经系统 (ANS) 不平衡,以高的交感和低的副交感活动为标志,加剧了手术结果. 通过各种策略恢复ANS平衡可以改善患者的康复并减少并发症.
科学领域:
- 生理学 生理学 生理学
- 麻醉学 麻醉学
- 免疫学 免疫学 免疫学
背景情况:
- 自主神经系统 (ANS) 失衡,其特点是交感过度激活和降低对交感音调,在外科手术期间很常见.
- 这种失调会导致全身应激反应,心血管不稳定,愈合障碍和免疫抑制,增加感染,神经认知衰退和器官功能障碍的风险.
研究的目的:
- 审查自主神经系统在器官调节中的作用.
- 为了探索外科手术前期脱机症的病理生理后果.
- 讨论以证据为基础的治疗策略,以恢复ANS平衡.
主要方法:
- 基本和临床研究的系统审查.
- 通过ANS介导的器官调节的分析.
- 对外科手术期间的 ANS 失衡治疗干预措施的评估.
主要成果:
- 在外科手术期间出现的ANS失衡会加剧应激反应,炎症和免疫抑制.
- 交感性过活性会增加catecholamine的释放和促炎性细胞因子.
- 低的副交感声调降低了胆固醇抗炎途径的有效性.
结论:
- 调节自主神经系统对于缓解术后并发症至关重要.
- 治疗策略,包括药理和非药理方法,显示出恢复ANS平衡的潜力.
- 保持同情-副同情平衡对于改善手术患者康复至关重要.
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