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神经外科术后谵妄的研究进展

Research progress of postoperative delirium in neurosurgery.

作者信息

Wang Xue-Jian

机构信息

Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, Nantong 226000, Jiangsu Province, China.

出版信息

World J Psychiatry. 2025 Apr 19;15(4):104708. doi: 10.5498/wjp.v15.i4.104708.

Abstract

Delirium is a transient and acute syndrome of encephalopathy, characterized by disturbances in consciousness, orientation, cognition, perception, and emotional regulation, often accompanied by hallucinations, illusions, psychomotor agitation, and restlessness. Postoperative delirium (POD), a common complication particularly in elderly patients, significantly impacts recovery by prolonging mechanical ventilation, neurosurgical intensive care unit stays, and overall hospitalization durations, while severely diminishing patients' quality of life after discharge. Despite its prevalence, POD remains underrecognized in clinical practice, with significant gaps in its diagnosis and management. This review explores the definition, diagnostic criteria, underlying pathogenesis, and associated risk factors of POD in neurosurgical patients, aiming to offer valuable insights for improving clinical diagnosis and therapeutic strategies.

摘要

谵妄是一种短暂的急性脑病综合征,其特征为意识、定向、认知、感知及情绪调节障碍,常伴有幻觉、错觉、精神运动性激越及烦躁不安。术后谵妄(POD)是一种常见并发症,尤其在老年患者中,它会通过延长机械通气时间、神经外科重症监护病房住院时间及总体住院时长而显著影响恢复,同时严重降低患者出院后的生活质量。尽管其很常见,但POD在临床实践中仍未得到充分认识,其诊断和管理存在重大差距。本综述探讨神经外科患者POD的定义、诊断标准、潜在发病机制及相关危险因素,旨在为改善临床诊断和治疗策略提供有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aee6/12038677/8e9ec9cc0d32/104708-g001.jpg

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