Zhang Zhen-Rong, Li Yang-Zheng, Wu Xiao-Qing, Chen Wen-Jun, Xu Jian, Zhao Wei-Hua, Gong Xiao-Yan
Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Department of Rehabilitation Medicine, The First People's Hospital of Shizuishan, Shizuishan, Ningxia, China.
Front Rehabil Sci. 2024 Dec 17;5:1525813. doi: 10.3389/fresc.2024.1525813. eCollection 2024.
Postoperative cognitive dysfunction (POCD) is a prevalent complication of the central nervous system in elderly patients following cardiac surgery. This review aims to provide an overview of the etiology, risk factors, diagnostic assessment, and rehabilitation strategies for cognitive dysfunction occurring after cardiac surgery. The pathogenesis of POCD after cardiac surgery includes cerebral microembolism, neuroinflammation, and cryptogenic strokes. Risk factors are associated with advanced age, diminished preoperative cognitive status, and anesthesia. Cognitive function screening tools used for pre- and postoperative assessments can detect changes in patients' cognitive levels in a timely manner. The timely provision of appropriate rehabilitation methods, including cognitive function training, exercise training, transcranial direct current stimulation, and perioperative acupuncture, is crucial, with emerging technologies such as virtual reality playing an increasingly significant role. In conclusion, POCD is a common postoperative complication in elderly cardiac surgery patients, with age and reduced preoperative cognitive function being the primary risk factors. A comprehensive rehabilitation strategy can more effectively address postoperative cognitive dysfunction in patients.
术后认知功能障碍（POCD）是老年患者心脏手术后常见的中枢神经系统并发症。本综述旨在概述心脏手术后发生的认知功能障碍的病因、危险因素、诊断评估和康复策略。心脏手术后POCD的发病机制包括脑微栓塞、神经炎症和隐源性卒中。危险因素与高龄、术前认知状态减退和麻醉有关。用于术前和术后评估的认知功能筛查工具可以及时检测患者认知水平的变化。及时提供适当的康复方法，包括认知功能训练、运动训练、经颅直流电刺激和围手术期针灸，至关重要，虚拟现实等新兴技术发挥着越来越重要的作用。总之，POCD是老年心脏手术患者常见的术后并发症，年龄和术前认知功能减退是主要危险因素。综合康复策略可以更有效地解决患者术后认知功能障碍问题。
