Dijkstra Jeanette B, Jolles Jellemer
Department of Psychiatry and Neuropsychology, University Hospital Maastricht, The Netherlands.
Neuropsychol Rev. 2002 Mar;12(1):1-14. doi: 10.1023/a:1015404122161.
This review describes the discrepancy in findings between postoperative cognitive performance and postoperative cognitive complaints long time after an operation under general anesthesia. Shortly (from 6 hr to 1 week) after an operation a decline in cognitive performance is reported in most studies. However, long time (from 3 weeks to 1-2 years) after an operation this is rarely found although some patients are still reporting cognitive complaints. In general this kind of research is suffering from severe methodological problems (use of insensitive tests, lack of control groups, lack of parallel tests, different definitions of cognitive decline). However, these problems cannot totally explain the discrepancy in findings in the long term. Thus, there are patients who have persistent cognitive complaints long time after an operation, that cannot be measured with cognitive tests. More psychological factors such as fixation on short-term cognitive dysfunction, mood, coping style, and personality are possible explanations for these cognitive complaints in the long term. As a consequence, these factors should be a topic in future research elucidating the persistence of these cognitive complaints long time after an operation under general anesthesia.
这篇综述描述了全身麻醉手术后很长一段时间内，术后认知表现与术后认知主诉之间的研究结果差异。在大多数研究中，术后不久（6小时至1周）认知表现会出现下降。然而，术后很长时间（3周至1 - 2年），尽管仍有一些患者报告存在认知主诉，但这种情况却很少被发现。总体而言，这类研究存在严重的方法学问题（使用不敏感的测试、缺乏对照组、缺乏平行测试、对认知衰退的定义不同）。然而，这些问题并不能完全解释长期研究结果中的差异。因此，有些患者在术后很长时间仍有持续性认知主诉，但无法通过认知测试来衡量。更多的心理因素，如对短期认知功能障碍的执着、情绪、应对方式和个性，可能是这些长期认知主诉的解释。因此，这些因素应该成为未来研究的一个主题，以阐明全身麻醉手术后这些认知主诉长期存在的原因。
