van Dijk D, Dieleman J M, Hijman R
Universitair Medisch Centrum Utrecht, huispostnummer Q.04.2-313, Postbus 85.500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2007 May 26;151(21):1163-6.
Memory loss and lack of concentration are symptoms that frequently occur in patients who have undergone a surgical procedure. Although cognitive function can be assessed using neuropsychological tests, diagnosing postoperative cognitive decline (POCD) reliably appears to be difficult. Therefore, the true incidence of POCD is unknown. Severe POCD, which is apparent even without neuropsychological testing, is predominantly reported after cardiac and hip-replacement surgery. In these cases, POCD probably reflects micro embolic brain injury. Apart from the nature of the surgical procedure, advanced age is the most important risk factor for POCD. The anaesthetic technique used is not a determinant: the risks of POCD occurring appear to be similar following both general and local anaesthesia.
记忆力减退和注意力不集中是接受过外科手术的患者经常出现的症状。尽管可以使用神经心理学测试来评估认知功能,但可靠地诊断术后认知功能下降(POCD)似乎很困难。因此,POCD的真实发病率尚不清楚。即使不进行神经心理学测试也很明显的严重POCD主要在心脏手术和髋关节置换手术后被报道。在这些情况下,POCD可能反映了微栓塞性脑损伤。除了手术的性质外,高龄是POCD最重要的危险因素。所使用的麻醉技术不是一个决定性因素:全身麻醉和局部麻醉后发生POCD的风险似乎相似。