Postoperative cognitive dysfunction in elderly postcardiac surgery patients: progress in rehabilitation application research.

IF 1.3 Q3 REHABILITATION Frontiers in rehabilitation sciences Pub Date : 2024-12-17 eCollection Date: 2024-01-01 DOI:10.3389/fresc.2024.1525813
Zhen-Rong Zhang, Yang-Zheng Li, Xiao-Qing Wu, Wen-Jun Chen, Jian Xu, Wei-Hua Zhao, Xiao-Yan Gong
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Abstract

Postoperative cognitive dysfunction (POCD) is a prevalent complication of the central nervous system in elderly patients following cardiac surgery. This review aims to provide an overview of the etiology, risk factors, diagnostic assessment, and rehabilitation strategies for cognitive dysfunction occurring after cardiac surgery. The pathogenesis of POCD after cardiac surgery includes cerebral microembolism, neuroinflammation, and cryptogenic strokes. Risk factors are associated with advanced age, diminished preoperative cognitive status, and anesthesia. Cognitive function screening tools used for pre- and postoperative assessments can detect changes in patients' cognitive levels in a timely manner. The timely provision of appropriate rehabilitation methods, including cognitive function training, exercise training, transcranial direct current stimulation, and perioperative acupuncture, is crucial, with emerging technologies such as virtual reality playing an increasingly significant role. In conclusion, POCD is a common postoperative complication in elderly cardiac surgery patients, with age and reduced preoperative cognitive function being the primary risk factors. A comprehensive rehabilitation strategy can more effectively address postoperative cognitive dysfunction in patients.

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老年心脏手术后患者术后认知功能障碍康复应用研究进展
术后认知功能障碍(POCD)是老年心脏手术后中枢神经系统的常见并发症。本文综述了心脏手术后认知功能障碍的病因、危险因素、诊断评估和康复策略。心脏手术后POCD的发病机制包括脑微栓塞、神经炎症和隐源性中风。危险因素与高龄、术前认知状态下降和麻醉有关。用于术前和术后评估的认知功能筛查工具可以及时发现患者认知水平的变化。及时提供适当的康复方法,包括认知功能训练、运动训练、经颅直流电刺激和围手术期针灸,是至关重要的,虚拟现实等新兴技术发挥着越来越重要的作用。综上所述,POCD是老年心脏手术患者术后常见的并发症,年龄和术前认知功能下降是主要危险因素。综合康复策略可以更有效地解决患者术后认知功能障碍。
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