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妇科手术后的术后认知功能障碍(POCD):当前观点与未来应用

Post-operative cognitive decline (POCD) after gynaecologic surgery: current opinions and future applications.

作者信息

Zarbo Cristina, Brivio Michela, Brugnera Agostino, Malandrino Chiara, Trezzi Gaetano, Rabboni Massimo, Bondi Emi, Compare Angelo, Frigerio Luigi

机构信息

Department of Human and Social Science, University of Bergamo, Bergamo, Italy.

Department of Obstetrics and Gynaecology, Hospital Papa Giovanni XXIII, Bergamo, Italy.

出版信息

Arch Gynecol Obstet. 2018 Mar;297(3):551-554. doi: 10.1007/s00404-017-4630-3. Epub 2017 Dec 19.

Abstract

OBJECTIVE

Postoperative cognitive decline (POCD) is known to occur quite frequently after a cardiac surgery, especially in older population. Few studies specifically focused on its incidence and characteristics in gynecological setting.

METHODS

Current opinions and future applications of POCD studies in gynecological setting have been discussed.

RESULT

There are still many questions and issues about POCD in gynecological setting that remain unanswered as well as numerous research fields that have not been still explored. In particular, from this article emerges the need of further studies in gynecological setting focusing on: (a) the evaluation of long-term effect of POCD (e.g. over 3 months after surgery); (b) elderly population; (c) a wide range of cognitive functions (memory, attention, concentration, orientation, etc.); (d) the evaluation of risk and protective factors for subsequent POCD development; (e) the relationships between POCD and previous psychological or neuroendocrine factors; (f) the difference on POCD outcomes between different anaesthesia and disorders.

CONCLUSION

Promoting studies on this topic is significant for the reduction of sociosanitary costs, mortality rates, social dependences and the likelihood of comorbidity.

摘要

目的

已知心脏手术后经常会发生术后认知功能障碍(POCD),尤其是在老年人群中。很少有研究专门关注其在妇科手术中的发生率和特征。

方法

讨论了POCD研究在妇科手术中的当前观点和未来应用。

结果

关于妇科手术中POCD仍有许多问题未得到解答,还有许多研究领域尚未探索。特别是,从本文中可以看出,在妇科手术中需要进一步开展研究,重点关注:(a)POCD的长期影响评估(例如手术后3个月以上);(b)老年人群;(c)广泛的认知功能(记忆、注意力、专注力、定向力等);(d)后续POCD发生的风险和保护因素评估;(e)POCD与先前心理或神经内分泌因素之间的关系;(f)不同麻醉方式和疾病之间POCD结果的差异。

结论

推动该主题的研究对于降低社会卫生成本、死亡率、社会依赖程度和合并症发生可能性具有重要意义。

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