Czyż-Szypenbejl Katarzyna, Mędrzycka-Dąbrowska Wioletta, Kwiecień-Jaguś Katarzyna, Lewandowska Katarzyna
Gdański Uniwersytet Medyczny, Zakład Pielęgniarstwa Anestezjologicznego i Intensywnej Opieki.
Psychiatr Pol. 2019 Feb 28;53(1):145-160. doi: 10.12740/PP/90648.
AIM: The aim of this systematic review was to summarize the present literature on cognitive dysfunctions in adults after surgical procedures. METHODS: MEDLINE: PubMed, OVID, Web of Science, EBSCO databases have been searched using relevant key words. The literature on cognitive dysfunctions after surgical procedures has been reviewed and the risk factors of POCD occurrence have been analyzed. RESULTS: The results from seven articles describing neuropsychological studies of 2,796 patients have been analyzed. The tests were conducted within a very short time after the procedure (7 days), within a short time (3 months) and within a long-term perspective (12-60 months). POCD within a very short time after the operation occurred with a different frequency: from 17 to 56% with a tendency to resolve over time (3-34.2%). POCD risk factors have been identified: advanced age, insulin resistance, a short education period. The type of surgical procedure, anesthesia or microembolization related to CPB, does not influence the occurrence of POCD. CONCLUSIONS: It seems that one should focus on searching risk factors outside the procedures, and that certain recommendations should be developed regarding perioperative proceedings which might be beneficial for patients at risk of the impairment of their cognitive functions after a surgical procedure.
目的:本系统评价的目的是总结目前关于成人手术后认知功能障碍的文献。 方法:使用相关关键词检索了MEDLINE:PubMed、OVID、Web of Science、EBSCO数据库。回顾了关于手术后认知功能障碍的文献,并分析了术后认知功能障碍发生的危险因素。 结果:分析了7篇描述对2796例患者进行神经心理学研究的文章的结果。测试在手术后很短时间内(7天)、短时间内(3个月)和长期(12 - 60个月)进行。术后极短时间内发生的术后认知功能障碍频率不同:从17%到56%,且有随时间缓解的趋势(3% - 34.2%)。已确定术后认知功能障碍的危险因素:高龄、胰岛素抵抗、受教育时间短。手术类型、与体外循环相关的麻醉或微栓塞并不影响术后认知功能障碍的发生。 结论:似乎应该关注手术以外的危险因素的研究,并且应该针对围手术期过程制定某些建议,这可能对手术后有认知功能受损风险的患者有益。
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