Zhuang Yi-Ming, Xu Ji-Yang, Zheng Kun, Zhang Hong
Department of Anesthesiology Affiliated Hospital of Zunyi Medical University Zunyi China.
Department of Anesthesiology Judicial Police Hospital of Guizhou Province Guiyang China.
Ibrain. 2023 Aug 14;10(3):290-304. doi: 10.1002/ibra.12123. eCollection 2024 Fall.
Cardiopulmonary bypass (CPB) is often used in cardiothoracic surgery because its nonphysiological state causes pathophysiological changes in the body, causing multiorgan and multitissue damage to varying degrees. Postoperative cognitive dysfunction (POCD) is a common central nervous system complication after cardiac surgery. The etiology and mechanism of POCD are not clear. Neuroinflammation, brain mitochondrial dysfunction, cerebral embolism, ischemia, hypoxia, and other factors are related to the pathogenesis of POCD. There is a close relationship between CPB and POCD, as CPB can cause inflammation, hypoxia and reperfusion injury, and microemboli formation, all of which can trigger POCD. POCD increases medical costs, seriously affects patients' quality of life, and increases mortality. Currently, there is a lack of effective treatment methods for POCD. Commonly used methods include preoperative health management, reducing inflammation response during surgery, preventing microemboli formation, and implementing individualized rehabilitation programs after surgery. Strengthening preventive measures can minimize the occurrence of POCD and its adverse effects.
体外循环（CPB）常用于心胸外科手术，因为其非生理状态会导致机体发生病理生理变化，引起多器官和多组织不同程度的损伤。术后认知功能障碍（POCD）是心脏手术后常见的中枢神经系统并发症。POCD的病因和机制尚不清楚。神经炎症、脑线粒体功能障碍、脑栓塞、缺血、缺氧等因素与POCD的发病机制有关。CPB与POCD之间存在密切关系，因为CPB可引起炎症、缺氧和再灌注损伤以及微栓子形成，所有这些都可引发POCD。POCD增加了医疗费用，严重影响患者的生活质量，并增加死亡率。目前，POCD缺乏有效的治疗方法。常用的方法包括术前健康管理、减少手术期间的炎症反应、预防微栓子形成以及术后实施个性化康复计划。加强预防措施可将POCD的发生及其不良影响降至最低。
