Pervin Farzana, Edwards Carolyn, Lippa Carol F
Drexel University College of Medicine, Philadelphia, PA, USA
Drexel University College of Medicine, Philadelphia, PA, USA.
Am J Alzheimers Dis Other Demen. 2016 Feb;31(1):5-17. doi: 10.1177/1533317515581704. Epub 2015 May 24.
Patients who have dementia with Lewy bodies (DLB) and undergo surgery may develop aggravated postoperative cognitive dysfunction or postoperative delirium. Many patients with DLB respond poorly to surgery and anesthesia, and their conditions may worsen if they have other medical complications along with dementia. They may also face high risk of prolonged hospital stay, increased medical problems and/or mortality, causing significant physical, psychosocial, and financial burdens on individuals, family members, and society. Anesthesia, pain medications, old age, and surgery-related stresses are usually held responsible for the complications; however, the exact causes are still not fully understood. Literature on surgery-related complications for patients with DLB appears to be inadequate, and hence the topic merits detailed and systematic research. This article reviews postoperative complications and various surgery-related risk factors for DLB in light of other dementias such as Alzheimer's disease, as their neuropathologic features overlap with those of DLB.
患有路易体痴呆(DLB)的患者接受手术后可能会出现术后认知功能障碍加重或术后谵妄。许多DLB患者对手术和麻醉反应不佳,如果他们除痴呆外还伴有其他医疗并发症,其病情可能会恶化。他们还可能面临住院时间延长、医疗问题增加和/或死亡的高风险,给个人、家庭成员和社会带来巨大的身体、心理社会和经济负担。麻醉、止痛药物、高龄和手术相关应激通常被认为是并发症的原因;然而,确切原因仍未完全明确。关于DLB患者手术相关并发症的文献似乎不足,因此该主题值得进行详细而系统的研究。鉴于其他痴呆症(如阿尔茨海默病)与DLB的神经病理学特征重叠,本文根据这些痴呆症综述了DLB的术后并发症及各种手术相关风险因素。