背景 人口老龄化问题加剧及老年医学的发展,致使老年患者手术量逐年上升,随之而来的围术期并发症严重影响老年人的康复期生活质量。术后认知功能障碍(postoperative cognitive dysfunction, POCD)是主要并发症之一,其影响因素众多,其中急性贫血已被大量研究证实是重要的危险因素。 目的 综述POCD的发病机制及术中急性贫血与老年患者POCD的关系,为预防和治疗该并发症提供合理思路。 内容 POCD的三大影响因素:自身、麻醉及手术,急性贫血对POCD的影响,包括发病机制与可能治疗策略。 趋向 深入研究术中急性失血性贫血引起POCD的具体发病机制及了解其贫血临界值和治疗阈值,对临床上预防和治疗POCD具有重要意义。
Background Along with the exacerbation of the aging process and the development of geriatric medicine, more and more elderly patients accepting surgeries from minor to major,as cures, but many of perioperative and postoperative complications have seriously affected their life quality during recovery period. Postoperative cognitive dysfunction (POCD) is one of the main complications, which is influenced by many factors, such as patients' basic situation, anesthesia and operation. A number of researches has proved that acute anemia is one of the moste important risk factors to POCD, though the underlying mechanism is not clearly understood. Objective In this paper, the latest studies of the pathogenesis of POCD and its association with intraoperative acute anemia were reviewed in order to provide reasonable and practical means for prevention and treatment of such complications. Content The main factors contribute to POCD and association between acute anemia and POCD,including the pathogenesis and treatment. Trend The dangerous critical value of anemia to POCD and transfusion thresholds still undefined at present, are helpful for therapeutic option for POCD and worth further exploration.
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