国际麻醉学与复苏杂志   2020, Issue (1): 0-0
    
儿童前期麻醉暴露对神经系统功能发育影响的临床研究进展
李嘉欣, 菅敏钰, 董佳, 曾敏, 彭宇明1()
1.首都医科大学附属北京天坛医院
Progress in the clinical research on the effects of early anesthetic exposure on the development of neurological system function in children
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摘要:

儿科手术量逐年增加,部分研究认为,长时间或反复接触全身麻醉药可能会影响儿童神经系统功能的发育。目前大量动物研究支持上述结论,但是临床研究的证据还不充分。文章通过深入了解儿童早期麻醉暴露对远期神经功能发育的影响,旨在对患儿治疗方式和手术时间选择进行指导。文章更新汇总了目前的研究进展,分析儿童早期麻醉暴露与远期神经功能发育缺陷之间的联系,以及在此过程中麻醉暴露年龄的敏感期。目前临床研究涉及不同年龄群体、不同类型的结局指标,因此对结局的解释需要结合麻醉暴露年龄、暴露时长、研究样本量、结局指标和涉及的混杂因素等。多数大样本研究发现,儿童早期麻醉暴露与远期神经功能发育缺陷有联系,且麻醉暴露的频率也有一定影响。

关键词: 儿童; 麻醉; 神经毒性; 神经发育
Abstract:

The number of pediatric surgery grows every year. Some studies found that long or repeated exposure to general anesthetics may affect the development of neurological system function in children. This finding is supported by a large number of animal researches currently, without sufficient clinical evidence. This review was to explore the effects of early anesthetic exposure on long‑term neurodevelopment in children, so as to provide guidance to determine treatment method and surgery time. This review summarized the latest research progresses, and analyzed the association between early anesthetic exposure in childhood and long‑term neurodevelopmental deficits and the sensitive period of the age exposed to anesthesia. At present, clinical researches involve different age populations and types of outcomes. Therefore, the interpretation of outcomes needs the combination of the age exposed to anesthesia, duration of exposure, sample size, outcome indicators, and other factors. It is found that anesthesia exposure in early childhood is associated with long‑term neurological deficits, and affected by the frequency of anesthetic exposure to some extent.

Key words: Children; Anesthesia; Neurotoxicity; Neurodevelopment