在接受心脏手术的老年患者中经历手术期间的神经认知障碍:机制,生物标志物和预防
Xiao Xu1, Duanqi Zhu1, Yefei Wu1
1Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Journal of cardiothoracic and vascular anesthesia
|February 20, 2026
概括
外科手术期间的神经认知障碍 (PND) 在老年心脏手术患者中很常见. 本综述总结了PND机制,风险因素,生物标志物和预防策略,以改善患者的治疗结果.
科学领域:
- 老年学是一门学科.
- 神经科学是一个神经科学.
- 心脏病学 心脏病学
背景情况:
- 术后神经认知障碍 (PND),包括术后妄想和认知功能障碍,是心脏手术后老年患者的重大并发症.
- 这些疾病导致长时间住院,增加发病率,以及认知功能和生活质量长期下降.
研究的目的:
- 为提供有关老年心脏手术患者PND的当前文献的简要综述.
- 总结PND病理生理学,风险因素,生物标志物和预防策略.
- 识别知识缺口,并建议未来的研究方向.
主要方法:
- 文献综述综合了关于PND的现有研究.
- 专注于机制,风险因素,诊断生物标志物和预防性干预措施.
- 对早期检测和管理策略的证据分析.
主要成果:
- PND是由多因素机制造成的,包括神经炎症,大脑低 perfusion 和神经退行.
- 关键的危险因素包括晚年,先前存在的认知障碍和脑血管疾病.
- 生物标志物和诸如认知评估和手术内监测等干预措施在检测和预防方面表现有前途.
结论:
- 了解PND病理生理学对于开发有效的干预措施至关重要.
- 通过生物标志物和主动管理策略的早期检测可以减轻PND的影响.
- 需要进一步的研究,以充分阐明PND机制,并优化预防老年心脏手术患者.
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