Yang Yan, Xu Zhipeng, Guo Jianrong, Xiong Zhiqiang, Hu Baoji
Department of Anesthesiology, Xuzhou Renci Hospital, Xuzhou, 221000, Jiangsu Province, China.
Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai, 201399, China.
Brain Behav Immun Health. 2024 Mar 29;38:100763. doi: 10.1016/j.bbih.2024.100763. eCollection 2024 Jul.
Postoperative Cognitive Dysfunction (POCD) is a common yet poorly understood complication of surgery that can lead to long-term cognitive decline. The gut-brain axis, a bidirectional communication system between the central nervous system and the gut microbiota, plays a significant role in maintaining cognitive health. The potential for anesthetic agents and perioperative medications to modulate the gut microbiota and influence the trajectory of POCD suggests the need for a more integrated approach in perioperative care. Perioperative medications, including opioids and antibiotics, further compound these disruptions, leading to dysbiosis and consequent systemic and neuroinflammation implicated in cognitive impairment. Understanding how surgical interventions and associated treatments affect this relationship is crucial for developing strategies to reduce the incidence of POCD. Strategies to preserve and promote a healthy gut microbiome may mitigate the risk and severity of POCD. Future research should aim to clarify the mechanisms linking gut flora alterations to cognitive outcomes and explore targeted interventions, such as probiotic supplementation and microbiota-friendly prescription practices, to safeguard cognitive function postoperatively.
术后认知功能障碍（POCD）是一种常见但了解不足的手术并发症，可导致长期认知衰退。肠-脑轴是中枢神经系统与肠道微生物群之间的双向通信系统，在维持认知健康方面发挥着重要作用。麻醉剂和围手术期药物调节肠道微生物群并影响POCD病程的可能性表明，围手术期护理需要采用更综合的方法。包括阿片类药物和抗生素在内的围手术期药物会进一步加剧这些紊乱，导致生态失调以及随之而来的与认知障碍相关的全身炎症和神经炎症。了解手术干预及相关治疗如何影响这种关系对于制定降低POCD发病率的策略至关重要。保护和促进健康肠道微生物群的策略可能会降低POCD的风险和严重程度。未来的研究应旨在阐明肠道菌群改变与认知结果之间的联系机制，并探索有针对性的干预措施，如补充益生菌和采用有利于微生物群的处方做法，以保护术后认知功能。
