从长椅到床边:理解和治疗术后妄想的新前沿
Kenneth Meza Monge1, Allison L B Shapiro2,3, Christina Coughlan4,5
1Division of G.I., Trauma, and Endocrine Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.
Journal of clinical medicine
|December 11, 2025
概括
手术后妄想,老年患者的神经认知问题,源于复杂的生物学因素. 了解这些机制有助于制定有针对性的干预措施,以改善患者的治疗结果.
科学领域:
- 神经科学是一个神经科学.
- 老年医学 老年医学
- 翻译研究是翻译研究.
背景情况:
- 手术后痴呆症 (POD) 是老年手术患者常见的严重并发症.
- 它导致显著的发病率,延长住院时间和持久的认知障碍.
- 底层的生物学机制和有效的干预措施需要进一步阐明.
研究的目的:
- 审查对POD生物机制的翻译研究.
- 探索新兴的针对POD的有针对性的干预措施.
- 将基础科学发现与POD预防和管理的临床实践联系起来.
主要方法:
- 主要生物医学数据库的综合文献搜索 (2018-2025年优先考虑).
- 综合研究多因素病理生理学,包括神经炎症,氧化应激和神经递质失调.
- 临床前模型 (老年动物) 和人体研究 (神经成像,基因组学,蛋白质组学) 的分析.
主要成果:
- POD病理生理学涉及失调的信号 (胆固醇,多巴胺),神经炎症,氧化应激和代谢问题.
- 关键的危险因素包括先前存在的认知障碍和虚弱,与这些生物通路有关.
- 生物标志物和遗传变异被确定用于风险分层;临床前疗法显示出希望,但临床结果是混合的.
结论:
- 将基础科学见解纳入临床护理是减少POD负担的关键.
- 建议进行全面的手术前评估和非药物治疗策略.
- 基于机制的预防措施对于老年手术患者的POD管理至关重要.
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