术后认知功能障碍发病机制的研究进展

术后认知功能障碍(POCD)是术前无精神障碍的患者受围术期各种因素的影响,在术后出现的神经并发症,表现为焦虑、认识障碍、记忆受损和人格改变。随着医疗技术水平的不断提高,围术期死亡率及手术和麻醉并发症大大降低,但POCD发病率未见明显改善,严重影响患者预后康复及远期生存质量,引起很多学者的关注。认识和分析POCD,成为当今麻醉管理的重要课题。POCD是多种影响因素共同作用的结果,评估方法较多且相对主观,没有标准统一的评估、预防、诊断及治疗方法,目前虽已有大量动物实验及临床研究,但其发病机制仍不明确。因此全面认识和分析POCD发病机制的进展情况,进一步探讨其预防和治疗方法,具有重要的临床和社会意义。

Progress of Pathogenesis of Postoperative Cognitive Dysfunction*

Postoperative cognitive dysfunction（POCD） refers to the central nervous system complications of the patients with no preoperative mental disorder after surgery, with the clinical manifestations of anxiety, cognitive impairment, impaired memory, personality changes and so on. With the development of medical technology, perioperative mortality and complications of surgery and anesthesia is greatly reduced. But the incidence of POCD has not improved obviously, affecting the postoperative prognosis of patients and the long-term quality of life. POCD has made the attention of many scholars, becoming an important subject for anaesthetist to study and analyse. There are a lot of factors resulting in POCD and many assessment methods, with no standard evaluation,prevention, diagnosis and treatment. Although there are a large number of animal and clinical research, the pathogenesis is still unclear. Therefore, a compre- hensive analysis of the pathogenesis about the development of POCD and discussing the method of prevention and treatment have an im- portant clinical and social significance.