心肺旁路下心脏手术术后认知功能障碍的研究进展

Ibrain Pub Date : 2023-08-14 DOI:10.1002/ibra.12123
Yi-Ming Zhuang, Ji-Yang Xu, Kun Zheng, Hong Zhang
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引用次数: 0

摘要

心胸手术中经常使用心肺旁路(CPB),因为其非生理状态会引起机体的病理生理变化,造成不同程度的多器官和多组织损伤。术后认知功能障碍(POCD)是心脏手术后常见的中枢神经系统并发症。认知功能障碍的病因和机制尚不清楚。神经炎症、脑线粒体功能障碍、脑栓塞、缺血、缺氧等因素与 POCD 的发病机制有关。CPB 与 POCD 关系密切,因为 CPB 可引起炎症、缺氧和再灌注损伤以及微栓子形成,所有这些因素都可诱发 POCD。POCD 会增加医疗费用,严重影响患者的生活质量,并增加死亡率。目前,POCD 缺乏有效的治疗方法。常用的方法包括术前健康管理、术中减轻炎症反应、预防微栓子形成、术后实施个性化康复计划等。加强预防措施可以最大限度地减少 POCD 的发生及其不良影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Research progress of postoperative cognitive dysfunction in cardiac surgery under cardiopulmonary bypass

Cardiopulmonary bypass (CPB) is often used in cardiothoracic surgery because its nonphysiological state causes pathophysiological changes in the body, causing multiorgan and multitissue damage to varying degrees. Postoperative cognitive dysfunction (POCD) is a common central nervous system complication after cardiac surgery. The etiology and mechanism of POCD are not clear. Neuroinflammation, brain mitochondrial dysfunction, cerebral embolism, ischemia, hypoxia, and other factors are related to the pathogenesis of POCD. There is a close relationship between CPB and POCD, as CPB can cause inflammation, hypoxia and reperfusion injury, and microemboli formation, all of which can trigger POCD. POCD increases medical costs, seriously affects patients' quality of life, and increases mortality. Currently, there is a lack of effective treatment methods for POCD. Commonly used methods include preoperative health management, reducing inflammation response during surgery, preventing microemboli formation, and implementing individualized rehabilitation programs after surgery. Strengthening preventive measures can minimize the occurrence of POCD and its adverse effects.

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