进化的术后妄想的临床管理:叙述性审查
Shahab Ahmadzadeh1, Drake P Duplechin2, Andrew T Haynes2
1Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA.
Cureus
|October 24, 2025
概括
手术后痴呆症 (POD) 是手术后老年人的常见并发症. 多组分非药物干预和德克斯梅德托米丁在减少其发生率和影响方面表现有前途.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 麻醉学 麻醉学
背景情况:
- 手术后痴呆症 (POD) 是手术后65岁及以上的成年人中最常见的神经复杂症.
- 它显著增加死亡率,延长住院时间,并导致长期认知能力下降.
- POD的多因素病变包括神经炎症,血脑屏障破坏和神经递质失衡.
研究的目的:
- 审查当前对POD病原体,风险因素和管理策略的理解.
- 突出基于证据的POD预防和治疗方法.
- 确定未来研究领域,以减轻POD的影响.
主要方法:
- 对有关POD发病率,风险因素和机制的现有文献的审查.
- 对非药物和药物预防策略的证据评估.
- 对POD的诊断工具和管理指南的评估.
主要成果:
- 非药物组合 (导向,早期动员,促进睡眠) 将POD发病率降低30-40%.
- 德克斯梅德托米丁输液有效降低特定手术群体的妄想率.
- 目前的证据不支持常规预防性使用抗精神病药物,黑激素激动剂或胆酶抑制剂.
结论:
- 识别有风险的患者和减轻可修改因素对于预防POD至关重要.
- 多组件非药物干预是预防POD的基石.
- 需要进一步的研究来优化血液动力学目标,麻醉剂定位和个性化的预防策略.
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