术前压力的负担:生物机制和术后结果
Aaqib Syed1,2, Tallita Menezes1, Andrew Bisenius1
1Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA.
Brain sciences
|February 27, 2026
概括
手术前的心理压力显著影响手术恢复,增加疼痛和并发症. 通过干预措施解决这种压力可以改善患者的治疗结果并降低风险.
科学领域:
- 麻醉学 麻醉学
- 心理学 心理学 心理学
- 外科手术的结果
背景情况:
- 手术前的心理压力在手术患者中很常见.
- 它影响了手术后的生理反应和恢复.
- 它对手术结果的影响往往被低估.
研究的目的:
- 审查证据,将手术前的压力与不良的手术结果联系起来.
- 探索包括HPA轴,皮质醇,炎症和疼痛在内的机制.
- 突出在术后护理中对压力评估和管理的需要.
主要方法:
- 对当前科学文献进行叙述性审查.
- 综合关于压力路径及其临床相关性的证据.
- 专注于HPA轴的功能,皮质醇动态,炎症信号和疼痛调节.
主要成果:
- 高度的手术前焦虑与增加的止痛剂/麻醉剂需求,更高的术后疼痛和慢性疼痛风险相关.
- 神经精神疾病并发症,代谢问题和感染也与压力有关.
- 皮质醇和白内素-6通过免疫,代谢和中枢神经系统途径调解作用.
结论:
- 手术前的压力是影响手术结果的可改变因素.
- 针对心理,止痛和代谢方面的干预措施可以增强康复.
- 将压力评估纳入外科手术期间风险分层是非常重要的,但有限的.
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